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1063144772
MIKENZY FERGUS
RIVERDALE, UT
NPI
1063144772
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2022-06-30
Last Update Date
2022-06-30
Business Address
MIKENZY FERGUS
5202 FREEWAY PARK DR
RIVERDALE, UT 84405-4016
Phone number: 801-255-5131
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Mailing Address
MIKENZY FERGUS
6013 S REDWOOD RD
TAYLORSVILLE, UT 84123-5220
Phone number:
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