DEREK R ELLSWORTH

SALT LAKE CITY, UT
NPI1386219301
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy106S00000X Behavior Technician
Enumeration Date2021-05-21
Last Update Date2021-05-21
Business Address
DEREK R ELLSWORTH
515 S 700 E STE 2A
SALT LAKE CITY, UT 84102-2855
Phone number: 801-935-4171
Mailing Address
DEREK R ELLSWORTH
116 E 700 N APT 2
PROVO, UT 84606-1710
Phone number: