Individual
BRAXTON LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RBT
Contact information
Practice address
6033 FASHION POINT DR, SOUTH OGDEN, UT 84403-4847
(801) 663-4316
Mailing address
1105 W RUSSELL ST, SIOUX FALLS, SD 57104-1322
(605) 271-2690
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-257300
UT
Other
Enumeration date
02/13/2023
Last updated
02/13/2023
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