Individual
DANIELLE RUTH BAETZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2940 N CHURCH ST STE 204, LAYTON, UT 84040-6616
(801) 599-4785
Mailing address
310 N 400 E, BOUNTIFUL, UT 84010-4724
(801) 599-4785
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
801203854
SELECT HEALTH
UT
Enumeration date
08/14/2020
Last updated
08/14/2020
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