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Individual

AMELIA MAREN DESPAIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
839 N 700 E APT 1, LOGAN, UT 84321-3568
(208) 539-6835
Mailing address
1392 W TURF FARM WAY STE 1-153, PAYSON, UT 84651-5587

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
05/28/2024
Last updated
05/31/2024
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