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NPI Code Detail

MEDICARE: ABIGAIL WAITE RBT

MEDICARE: ABIGAIL WAITE RBT
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 : 1194196154
Entity Type Code : Individual
Provider Name (Legal Business Name) : ABIGAIL WAITE RBT
Provider Business Mailing Address
First Line : 1443 W 800 N STE 103
Second Line :
City : OREM
State : UT
Zip : 84057-2878
Country : US
Telephone Number : 801-655-4950
Fax Number :
Provider Business Practice Location Address
First Line : 545 W 465 N STE 100
Second Line :
City : PROVIDENCE
State : UT
Zip : 84332-8004
Country : US
Telephone Number : 435-753-6606
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/15/2015
Last Update Date : 10/15/2015

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Directions to “ ABIGAIL WAITE RBT” Practice Location

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