Individual
JACKSON WARNER CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DIPLOMA, ASSOCIATES.
Contact information
Practice address
1870 N MAIN ST, CEDAR CITY, UT 84721-7744
(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
05
—
1396085718
—
UT
Enumeration date
08/08/2022
Last updated
09/22/2023
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