Healthcare Provider Details
I. General information
NPI: 1821871146
Provider Name (Legal Business Name): ABOVE AND BEYOND ABA UT LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/18/2023
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6949 S HIGH TECH DR
MIDVALE UT
84047-3705
US
IV. Provider business mailing address
7533 S CENTER VIEW CT STE R
WEST JORDAN UT
84084-5526
US
V. Phone/Fax
- Phone: 801-630-2040
- Fax:
- Phone: 801-630-2040
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106E00000X |
| Taxonomy | Assistant Behavior Analyst |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MATT
ROKOWSKY
Title or Position: MANAGER
Credential:
Phone: 801-630-2040