Individual
ELIZABETH JEAN WINFREY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
344 E 100 S STE 301, SALT LAKE CITY, UT 84111-1727
(801) 428-3487
Mailing address
344 E 100 S STE 301, SALT LAKE CITY, UT 84111-1727
(801) 428-3487
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
258033
PIN ID
—
Enumeration date
05/06/2022
Last updated
05/06/2022
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