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1003428640
TYLER BENNINK
HERRIMAN, UT
NPI
1003428640
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Additional Taxonomies
172V00000X Community Health Worker
Enumeration Date
2020-08-17
Last Update Date
2020-08-17
Business Address
TYLER BENNINK
13947 S NEWBURG DR
HERRIMAN, UT 84096-6787
Phone number: 801-506-6695
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Mailing Address
TYLER BENNINK
13947 S NEWBURG DR
HERRIMAN, UT 84096-6787
Phone number:
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