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1568220333
BROCKEN D LARSON
SOUTH JORDAN, UT
NPI
1568220333
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
103K00000X Behavior Analyst
(Licence: UT 12068508-2506)
Enumeration Date
2024-03-07
Last Update Date
2024-03-07
Business Address
BROCKEN D LARSON BCBA, LBA
10404 S 1055 W
SOUTH JORDAN, UT 84095-1514
Phone number: 801-855-9110
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Mailing Address
BROCKEN D LARSON BCBA, LBA
191 W 425 S
OGDEN, UT 84404-7349
Phone number: 385-439-4446
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