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Individual

ANGELA DIANTHA BLACKBURN WATSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2845 W 12600 S, RIVERTON, UT 84065-7147
(801) 930-5703
Mailing address
4444 S 700 E STE 203, MURRAY, UT 84107-3075
(801) 268-4887
(801) 268-4880

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
UT

Other

Enumeration date
03/03/2020
Last updated
03/03/2020
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