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1104690304
LELAJANE WIXOM
BOUNTIFUL, UT
NPI
1104690304
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2023-11-08
Last Update Date
2024-09-13
Business Address
LELAJANE WIXOM RBT
415 MEDICAL DR STE A100
BOUNTIFUL, UT 84010-4995
Phone number: 801-683-1062
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Mailing Address
LELAJANE WIXOM RBT
415 MEDICAL DR STE A100
BOUNTIFUL, UT 84010-4995
Phone number: 801-683-1062
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