Most Relevant Information
Provider Data
| NPI Number: | 1003372681 |
| Provider Name: | KRISTY HAZEL WILDER |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/19/2019 |
| Last Updated: | 02/19/2019 |
Provider Practice Location
1318 E WINDER LN
SALT LAKE CITY
UT
841241455
Practice Location Phone/Fax
| Phone: | 8015587111 |
| Fax: |
Provider Mailing Location
1318 E WINDER LN
SALT LAKE CITY
UT
841241455
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |