Individual
IFAN CASSANDRA POULSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6910 S HIGHLAND DR STE 1, COTTONWOOD HEIGHTS, UT 84121-3061
(801) 935-4171
Mailing address
1140 WEST 1130 S, BUILDING B, OREM, UT 84058-2888
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
UT
106E00000X
Assistant Behavior Analyst
—
—
Other
Enumeration date
11/19/2019
Last updated
10/25/2021
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