Individual
DEBRA TATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3431 S RIVIERA DR, SOUTH SALT LAKE, UT 84106-1226
(801) 865-6409
Mailing address
3431 S RIVIERA DR, SOUTH SALT LAKE, UT 84106-1226
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/05/2018
Last updated
10/05/2018
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