Organization
GRACIOUS GROWTH UTAH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AVI MARMORSTEIN (CEO)
(917) 771-4207
Entity
Organization
Contact information
Practice address
50 W BROADWAY, SUITE 333 - 999508, SALT LAKE CITY, UT 84101
(917) 771-4207
Mailing address
15 SKYLINE DR, THIELLS, NY 10984-1427
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
08/23/2024
Last updated
08/23/2024
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