Individual
JENNA LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1890 W ALEXANDER ST, WEST VALLEY, UT 84119-2037
(208) 908-8923
Mailing address
1890 W ALEXANDER ST, WEST VALLEY, UT 84119-2037
(208) 908-8923
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-26-547673
UT
Other
Enumeration date
06/23/2026
Last updated
06/23/2026
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