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1881904613
CODY JOHNSON
PROVO, UT
NPI
1881904613
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: UT 9082143-3501)
Enumeration Date
2010-10-14
Last Update Date
2019-04-17
Business Address
CODY JOHNSON
TRAILTALK 3585 N UNIVERSITY AVE. STE 250
PROVO, UT 84604
Phone number: 435-513-2715
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Mailing Address
CODY JOHNSON
263 ASHBROOK CIRCLE
MIDVALE, UT 84047
Phone number: 801-834-1606
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