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Individual

BRANDON E CONDIE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC, NCC, BCBA

Contact information

Practice address
570 E 1400 S, OREM, UT 84097-7714
(801) 634-7965
Mailing address
29 S STATE ST, #510, SALT LAKE CITY, UT 84111-1535
(801) 634-7965

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6148541-6004
UT
101YP2500X
Professional Counselor
C2057
OR
103K00000X
Behavior Analyst
1-09-5786
UT

Other

Enumeration date
01/27/2010
Last updated
01/27/2010
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