Individual
BRODY SCOTT PALMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6910 S HIGHLAND DR, SALT LAKE CITY, UT 84121-3060
(801) 935-4171
Mailing address
1552 MOON RIVER DR APT 8, PROVO, UT 84604-2467
(714) 393-4007
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
ABS
—
Enumeration date
05/27/2020
Last updated
05/27/2020
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