TY BRACKEN ALLER

PROVIDENCE, UT
NPI1386119600
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy106H00000X Marriage & Family Therapist
(Licence: UT  9560142-3902)
Enumeration Date2018-10-13
Last Update Date2018-10-29
Business Address
TY BRACKEN ALLER
545 W 465 N STE 130
PROVIDENCE, UT 84332-8005
Phone number: 385-200-3993
Mailing Address
TY BRACKEN ALLER
PO BOX 583
PROVIDENCE, UT 84332-0583
Phone number:
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