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Individual

DESTINY MICHELLE LUCIUS

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
4246 W ASCOT DOWNS DR, SOUTH JORDAN, UT 84009-7104
(720) 561-1671

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
01/29/2020
Last updated
01/29/2020
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