Individual
ETHAN SHEPARD ALLEN EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RBT
Contact information
Practice address
220 N 1200 E STE 102, LEHI, UT 84043-5863
(801) 655-4950
Mailing address
1443 W 800 N STE 103, OREM, UT 84057-2878
(801) 655-4950
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/02/2024
Last updated
08/02/2024
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