Audrey Tetryana Heru Hendarto

NPI #1518604248 in Slc, Utah

Provider Information

NPI Number: 1518604248
Entity Type: Individual
Name: Audrey Tetryana Heru Hendarto
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: May 15, 2022
Last Updated: May 15, 2022

Practice Location

Address: 344 E 100 S STE 301
City: Slc
State: Utah
ZIP Code: 84111-1727
Phone: (801) 428-4257

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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