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1215511191
BRANTLEIGH J BANNON
SALT LAKE CITY, UT
NPI
1215511191
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2021-05-07
Last Update Date
2021-05-07
Business Address
BRANTLEIGH J BANNON
515 S 700 E STE 2A
SALT LAKE CITY, UT 84102-2855
Phone number: 801-935-4171
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Mailing Address
BRANTLEIGH J BANNON
318 N 400 E APT 303
PROVO, UT 84606-8009
Phone number:
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