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Individual

IMOGEN WOLFERSTAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RBT

Contact information

Practice address
209 E GORDON AVE, LAYTON, UT 84041-2341
(801) 663-4316
Mailing address
209 E GORDON AVE, LAYTON, UT 84041-2341
(801) 663-4316

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
UT

Other

Enumeration date
07/13/2021
Last updated
07/13/2021
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