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1215716121
STAISY NDETA
SALT LAKE CITY, UT
NPI
1215716121
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2023-09-28
Last Update Date
2023-09-28
Business Address
STAISY NDETA
6910 S HIGHLAND DR STE 1
SALT LAKE CITY, UT 84121-3061
Phone number: 801-935-4171
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Mailing Address
STAISY NDETA
16255 VENTURA BLVD STE 830
ENCINO, CA 91436-2317
Phone number:
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