Individual
ANNALISSA KAYTE KIRBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1140 W 1130 S, SUITE B, OREM, UT 84058
(801) 935-4171
Mailing address
1285 E CENTER ST, PLEASANT GROVE, UT 84062-3031
(385) 273-9013
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/21/2021
Last updated
05/21/2021
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