Individual
BREANNA NICOLE WIRTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1140 W 1130 S, STE. B, OREM, UT 84058
(801) 935-4171
Mailing address
601 DEBBIE CT, PROSPER, TX 75078-0138
(214) 625-2318
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
UT
Other
Enumeration date
05/21/2021
Last updated
07/09/2025
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