Healthcare Provider Details

I. General information

NPI: 1376032433
Provider Name (Legal Business Name): ERIN ELIZABETH WHEATLEY M.ED., BCBA, LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2018
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6405 OLD MAIN HILL
LOGAN UT
84322-0001
US

IV. Provider business mailing address

6405 OLD MAIN HILL
LOGAN UT
84322-6405
US

V. Phone/Fax

Practice location:
  • Phone: 435-797-4200
  • Fax: 844-308-5865
Mailing address:
  • Phone: 919-376-6711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-18-34185
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-18-55033
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: