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NPI Code Detail

MEDICARE: KARI WATCHORN

MEDICARE: KARI WATCHORN
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
1106S00000XBehavior Technician
2103K00000XBehavior Analyst7349738-2506UT

General Provider Information

NPI Number : 1710484092
Entity Type Code : Individual
Provider Name (Legal Business Name) : KARI WATCHORN
Provider Business Mailing Address
First Line : 2540 E BENGAL BLVD STE 300
Second Line :
City : COTTONWOOD HEIGHTS
State : UT
Zip : 84121-5157
Country : US
Telephone Number : 801-495-5100
Fax Number :
Provider Business Practice Location Address
First Line : 2540 E BENGAL BLVD STE 300
Second Line :
City : COTTONWOOD HEIGHTS
State : UT
Zip : 84121-5157
Country : US
Telephone Number : 801-495-5100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2018
Last Update Date : 11/12/2020

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Directions to “ KARI WATCHORN ” Practice Location

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