Individual
ELENA DIANE POLYCHRONIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1315 PHEASANT WAY, PARK CITY, UT 84098-5533
(385) 232-6253
Mailing address
1315 PHEASANT WAY, PARK CITY, UT 84098-5533
(385) 232-6253
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB1177864
UT
Other
Enumeration date
03/05/2025
Last updated
03/05/2025
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