Individual
JESSICA FORSDICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
650 S KOMAS DR, SALT LAKE CITY, UT 84108-1215
(801) 581-5515
Mailing address
1266 E PARKWAY AVE, SALT LAKE CITY, UT 84106-2773
(801) 558-4521
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-17-30165
UT
Other
Enumeration date
04/13/2017
Last updated
04/13/2017
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