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Individual

TYLER GRANT GORHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RBT

Contact information

Practice address
401 N 2150 W, CEDAR CITY, UT 84721-4940
(801) 655-4950
Mailing address
401 N 2150 W, CEDAR CITY, UT 84721-4940

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
14208524-2506
UT
106S00000X
Behavior Technician
UT

Other

Enumeration date
12/07/2022
Last updated
03/06/2025
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