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1902458326
MIKAYLA ANN PORTER
TOOELE, UT
NPI
1902458326
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
106S00000X Behavior Technician
(Licence: UT RBT-19-92543)
Enumeration Date
2019-07-15
Last Update Date
2019-07-15
Business Address
MIKAYLA ANN PORTER
272 N BROADWAY ST # 101
TOOELE, UT 84074-2244
Phone number: 801-711-0273
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Mailing Address
MIKAYLA ANN PORTER
762 N 170 W
TOOELE, UT 84074-3503
Phone number:
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