Individual
JENNIFER LIDDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2940 N CHURCH ST STE 303, LAYTON, UT 84040-6617
(801) 935-4171
(801) 935-4946
Mailing address
421 WHEAT RIDGE CIR, KAYSVILLE, UT 84037-6804
(801) 475-4484
(801) 935-4946
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/20/2020
Last updated
07/20/2020
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