Individual
BARBRA SUZAN ORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
249 E TABERNACLE ST STE 100, ST GEORGE, UT 84770-2951
(435) 705-7574
Mailing address
249 E TABERNACLE ST STE 100, ST GEORGE, UT 84770-2951
(435) 705-7574
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
UT
172V00000X
Community Health Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1396085718
—
UT
Enumeration date
08/12/2019
Last updated
06/14/2021
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