Individual
CARISSA DUDLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8031 S 700 E, SANDY, UT 84070-0555
(385) 695-2203
Mailing address
30092 OLD LINCOLN HWY, WANSHIP, UT 84017-9607
(435) 671-6328
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/10/2022
Last updated
06/10/2022
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