Individual
JARED SOUTHWICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RBT
Contact information
Practice address
207 E GORDON AVE STE 4, LAYTON, UT 84041-2375
(801) 663-4316
(801) 513-5608
Mailing address
207 E GORDON AVE STE 4, LAYTON, UT 84041-2375
(801) 663-4316
(801) 513-5608
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
UT
Other
Enumeration date
11/20/2018
Last updated
11/20/2018
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