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1568229029
EDY MARK VICENTE
WEST JORDAN, UT
NPI
1568229029
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Additional Taxonomies
172V00000X Community Health Worker
Enumeration Date
2024-03-01
Last Update Date
2024-03-01
Business Address
EDY MARK VICENTE
1970 W 7800 S
WEST JORDAN, UT 84088-4025
Phone number: 801-916-3560
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Mailing Address
EDY MARK VICENTE
1970 W 7800 S
WEST JORDAN, UT 84088-4025
Phone number: 801-916-3560
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