Mckenzie Bolen

NPI #1093328478 in Draper, Utah

Provider Information

NPI Number: 1093328478
Entity Type: Individual
Name: Mckenzie Bolen
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Technician
Enumeration Date: Aug 26, 2020
Last Updated: Aug 26, 2020

Practice Location

Address: 12222 S 1000 E STE 3
City: Draper
State: Utah
ZIP Code: 84020-3203
Phone: (801) 987-3592

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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