Individual
KELLI VOYLYNN BASSETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
780 S GUARDSMAN WAY, SALT LAKE CITY, UT 84108-1374
(801) 581-0194
Mailing address
4460 S HIGHLAND DR, SALT LAKE CITY, UT 84124-3543
(801) 263-7100
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Enumeration date
06/05/2018
Last updated
06/05/2018
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