Provider Demographics
NPI:1780304394
Name:LABRUM, AARON
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:LABRUM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3772 S 3520 W
Mailing Address - Street 2:
Mailing Address - City:WEST VALLEY CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84119-4261
Mailing Address - Country:US
Mailing Address - Phone:801-244-8079
Mailing Address - Fax:
Practice Address - Street 1:3772 S 3520 W
Practice Address - Street 2:
Practice Address - City:WEST VALLEY CITY
Practice Address - State:UT
Practice Address - Zip Code:84119-4261
Practice Address - Country:US
Practice Address - Phone:801-244-8079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-01
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker