Individual
IRASEMA DIAZ HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1140 W 1130 S, BUILDING B, OREM, UT 84058-2888
(385) 227-8653
Mailing address
1639 WOODLAND DR, PROVO, UT 84604-1000
(208) 576-5005
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/20/2020
Last updated
03/20/2020
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