Most Relevant Information
Provider Data
| NPI Number: | 1003554924 |
| Provider Name: | MIRANDA WARREN |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/20/2022 |
| Last Updated: | 07/14/2022 |
Provider Practice Location
1970 W 7800 S
WEST JORDAN
UT
840884025
Practice Location Phone/Fax
| Phone: | 8012684887 |
| Fax: |
Provider Mailing Location
249 E TABERNACLE ST
SAINT GEORGE
UT
847702978
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |