Individual
JESSICA MYKENZIE CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
345 N STATE ROAD 198, SALEM, UT 84653-5719
(801) 423-3000
Mailing address
345 N STATE ROAD 198, SALEM, UT 84653-5719
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/09/2021
Last updated
09/09/2021
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