Individual
BREANNA TOOTHAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4505 S 2300 W, ROY, UT 84067-3321
(801) 940-4028
Mailing address
934 S MAIN ST, LAYTON, UT 84041-7135
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
9177208-3501
UT
Other
Enumeration date
08/13/2013
Last updated
07/08/2019
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