Individual
BRENAN R GODFREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RBT
Contact information
Practice address
169 N GATEWAY DR, PROVIDENCE, UT 84332-9707
(435) 915-6927
(435) 220-2030
Mailing address
87 S MAIN ST, CLARKSTON, UT 84305-7732
(801) 655-4950
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
14176565-3902
UT
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/04/2021
Last updated
06/18/2026
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