Individual
JENNA LUBEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6910 S HIGHLAND DR, COTTONWOOD HEIGHTS, UT 84121-3060
(801) 308-9113
Mailing address
6910 S HIGHLAND DR, COTTONWOOD HEIGHTS, UT 84121-3060
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106S00000X
—
UT
Enumeration date
06/17/2020
Last updated
06/17/2020
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