Individual
ABBY CROCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2811 N 2350 W, FARR WEST, UT 84404-5177
(801) 452-1940
Mailing address
1289 SANTA ANITA DR, KAYSVILLE, UT 84037-6780
(801) 505-3639
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/03/2024
Last updated
09/03/2024
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