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Individual

JAISHA REBECCA SEGO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1140 W. 1130 S., BUILDING B, OREM, UT 84058-2888
(801) 935-4171
(801) 935-4946
Mailing address
1849 N FREEDOM BLVD APT 138, PROVO, UT 84604-1527
(385) 404-9334

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
09/11/2019
Last updated
09/11/2019
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