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Individual

DYLAN WYATT JENSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RBT

Contact information

Practice address
545 W 465 N STE 100, PROVIDENCE, UT 84332-8004
(801) 655-4950
Mailing address
1443 W 800 N STE 103, OREM, UT 84057-2878
(801) 655-4950

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
UT

Other

Enumeration date
06/12/2024
Last updated
06/12/2024
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