Individual
GAYELENE HENRIKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6910 S HIGHLAND DR, COTTONWOOD HEIGHTS, UT 84121-3060
(435) 851-6325
Mailing address
163 CRYSTAL BAY DR, STANSBURY PARK, UT 84074-8000
(435) 851-6325
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/20/2020
Last updated
05/20/2020
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