Individual
JANAEA GENSEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
35 SKYLINE DR, BRIGHAM CITY, UT 84302-6772
(385) 264-4730
Mailing address
6013 S REDWOOD RD, TAYLORSVILLE, UT 84123-5220
(801) 255-5131
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
12347156-2506
UT
Other
Enumeration date
06/17/2018
Last updated
05/05/2022
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