GORDON JOHN WALLER

OREM, UT
NPI1780121731
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy106S00000X Behavior Technician
Additional Taxonomies101YM0800X Counselor, Mental Health
Enumeration Date2017-01-30
Last Update Date2021-01-12
Business Address
GORDON JOHN WALLER
475 W 260 N
OREM, UT 84057-1970
Phone number: 801-221-9930
Mailing Address
GORDON JOHN WALLER
475 W 260 N
OREM, UT 84057-1970
Phone number:
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