Individual
BRENDEN RAY TAMAYO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3113 W ROSE HILL ST, BOISE, ID 83705-1651
(208) 297-1405
Mailing address
1392 TURF FARM WAY STE 1-153, PAYSON, UT 84651-5587
(801) 935-5796
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-17-7295-60735
UT
Other
Enumeration date
05/15/2017
Last updated
11/08/2024
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