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NPI Code Detail

MEDICARE: TORI CHRUPALO M. ED, BCBA

MEDICARE: TORI CHRUPALO M. ED, BCBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1083275945
Entity Type Code : Individual
Provider Name (Legal Business Name) : TORI CHRUPALO M. ED, BCBA
Provider Business Mailing Address
First Line : 1441 E FT UNION BLVD
Second Line :
City : COTTONWOOD HEIGHTS
State : UT
Zip : 84121-2847
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1441 E FT UNION BLVD
Second Line :
City : COTTONWOOD HEIGHTS
State : UT
Zip : 84121-2847
Country : US
Telephone Number : 385-695-2203
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2019
Last Update Date : 06/21/2019

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