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1962856930
BRENT ANDREW TYCKSEN
PROVO, UT
NPI
1962856930
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: UT 10535183-3501)
Enumeration Date
2016-04-15
Last Update Date
2023-10-23
Business Address
BRENT ANDREW TYCKSEN LCSW
5600 NORTH 250 WEST
PROVO, UT 84604
Phone number: 801-226-4600
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Mailing Address
BRENT ANDREW TYCKSEN LCSW
173 E 10000 S
SALEM, UT 84653-9253
Phone number:
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