Healthcare Provider Details

I. General information

NPI: 1124643481
Provider Name (Legal Business Name): CAITLEN R SLOAN BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2020
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12222 S 1000 E STE 3
DRAPER UT
84020-3203
US

IV. Provider business mailing address

1814 E LONE OAK DR
DRAPER UT
84020-5520
US

V. Phone/Fax

Practice location:
  • Phone: 801-987-3592
  • Fax: 855-546-4955
Mailing address:
  • Phone: 816-209-8739
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number14238005-2506
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number19-83810
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: