Individual
ETHAN HANCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1159 E 200 N STE 100, AMERICAN FORK, UT 84003-2053
(801) 935-4171
Mailing address
16255 VENTURA BLVD STE 830, ENCINO, CA 91436-2317
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/19/2024
Last updated
03/19/2024
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