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1942054283
DRISTA LEE RICORD
BOUNTIFUL, UT
NPI
1942054283
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2024-04-15
Last Update Date
2024-04-15
Business Address
DRISTA LEE RICORD
415 MEDICAL DR STE A100
BOUNTIFUL, UT 84010-4995
Phone number: 801-683-1062
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Mailing Address
DRISTA LEE RICORD
415 MEDICAL DR STE A100
BOUNTIFUL, UT 84010-4995
Phone number: 801-683-1062
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