Individual
BRANDON HENSHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
415 MEDICAL DR STE D101, BOUNTIFUL, UT 84010-8905
(801) 683-1062
Mailing address
415 MEDICAL DR STE D101, BOUNTIFUL, UT 84010-8905
(801) 683-1062
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366928152
—
UT
Enumeration date
07/14/2018
Last updated
11/04/2020
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