Individual
DESTINI RUNYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
545 W 465 N STE 100, PROVIDENCE, UT 84332-8004
(435) 753-6606
Mailing address
1443 W 800 N STE 103, OREM, UT 84057-2878
(801) 655-4950
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
03/27/2016
Last updated
03/27/2016
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