Individual
JAYDALE LOGAN HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
986 W 9000 S STE 200, WEST JORDAN, UT 84088-5729
(385) 354-5250
Mailing address
986 W 9000 S STE 200, WEST JORDAN, UT 84088-5729
(385) 354-5250
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB1387936
UT
Other
Enumeration date
03/11/2026
Last updated
03/11/2026
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