Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 1125766004 | UT |
NPI | 1003141326 |
---|---|
Provider Name | Mrs. Brenda Wesson |
First Address | Springville, UT 84663-1350 |
Second Address | Springville, UT 84663-1350 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2009 |
Last Update Date | 30/11/2016 |