Individual
BLAKE THOMAS WELLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2811 N 2350 W, FARR WEST, UT 84404-5177
(801) 725-3977
Mailing address
2105 HARRISON BLVD, OGDEN, UT 84401-1917
(801) 725-3977
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
UT
Other
Enumeration date
05/25/2026
Last updated
05/25/2026
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