Individual
EMMA GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5558 S 1900 W, TAYLORSVILLE, UT 84129-9007
(801) 255-5131
Mailing address
6013 S REDWOOD RD, TAYLORSVILLE, UT 84123-5220
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104119619
BEHAVIOR TECH
UT
Enumeration date
07/27/2022
Last updated
07/27/2022
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