Provider Demographics
NPI:1871453092
Name:DE GARICA, LISA ANN ANN (FDN-P)
Entity type:Individual
Prefix:
First Name:LISA ANN
Middle Name:ANN
Last Name:DE GARICA
Suffix:
Gender:F
Credentials:FDN-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2876 W WILLOW WAY
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-5164
Mailing Address - Country:US
Mailing Address - Phone:385-484-1499
Mailing Address - Fax:
Practice Address - Street 1:2876 W WILLOW WAY
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-5164
Practice Address - Country:US
Practice Address - Phone:385-484-1499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-12
Last Update Date:2025-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach