Individual
EMI THEA ENDRIZZI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1140 W 1130 S, SUITE B, OREM, UT 84058
(801) 935-4171
Mailing address
1140 W 1130 S, SUITE B, OREM, UT 84058
(801) 935-4171
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
JZH124804373001
BLUE CROSS BLUE SHIELD
MN
Enumeration date
10/27/2020
Last updated
10/27/2020
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