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Individual

MISS GRACE ANNABELLE SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
515 S 700 E # 2, SALT LAKE CITY, UT 84102-2801
(800) 434-8923
Mailing address
515 S 700 E STE 2A, SALT LAKE CITY, UT 84102-2855

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
UT

Other

Enumeration date
07/18/2019
Last updated
12/07/2022
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