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Individual

JESSIE HEATON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
925 S 190 W, OREM, UT 84058-6829
(435) 830-9192
Mailing address
925 S 190 W, OREM, UT 84058-6829
(435) 830-9192

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
11/28/2020
Last updated
11/28/2020
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