BRANT TIDWELL

SALT LAKE CITY, UT
NPI1194023606
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: UT  380829-3503)
Enumeration Date2011-03-08
Last Update Date2011-03-08
Business Address
-- BRANT TIDWELL
5965 S 900 E
SALT LAKE CITY, UT 84121-1720
Phone number: 801-263-7100
Mailing Address
-- BRANT TIDWELL
5965 S 900 E
SALT LAKE CITY, UT 84121-1720
Phone number: 801-263-7100
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