Larson, Brocken D
Larson, Brocken D is an individual health care provider with primary practice located at 10404 S 1055 W , South Jordan UT 84095-1514. He recently has only one registered license in Behavioral Health & Social Service Providers / Behavioral Analyst, which is considered as his primary health care specialty. Larson, Brocken D can be contacted via phone (801) 855-9110.Contact Information
Primary practice address
10404 S 1055 W
South Jordan UT 84095-1514
Phone: (801) 855-9110
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Behavioral Analyst | 103K00000X | 12068508-2506 | Utah |
Profile Details
| NPI number | 1568220333 |
|---|---|
| LBN Legal business name | Larson, Brocken D |
| Credentials | BCBA, LBA |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 7th, 2024 |
| Last updated | Mar 7th, 2024 - about 8 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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