Individual
BREANNA STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4933 S 1500 W STE 210, RIVERDALE, UT 84405-7738
(801) 739-5355
Mailing address
1443 W 800 N STE 103, OREM, UT 84057-2878
(801) 739-5355
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
1-17-27675
UT
Other
Enumeration date
05/11/2022
Last updated
05/11/2022
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