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Individual

BRAYDEN RICHARD JENSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MS

Contact information

Practice address
1136 E WILMINGTON AVE, SALT LAKE CITY, UT 84106-2819
(801) 581-2221
Mailing address
1136 E WILMINGTON AVE, SALT LAKE CITY, UT 84106-2819

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
11055094-4104
UT

Other

Enumeration date
11/26/2018
Last updated
12/14/2021
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