Individual
EMILY MORTENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
525 E 4500 S STE F220, MILLCREEK, UT 84107-3150
(509) 992-4578
Mailing address
935 E 2985 N, LAYTON, UT 84040
(801) 771-0273
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-90516
UT
Other
Enumeration date
07/12/2019
Last updated
07/12/2019
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