Healthcare Provider Details

I. General information

NPI: 1972413979
Provider Name (Legal Business Name): GABRIELLA NICOLE CASSELMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GABRIELLA NICOLE ALLEN

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1460 S STATE ST UNIT A315
OREM UT
84097-7817
US

IV. Provider business mailing address

1460 S STATE ST UNIT A315
OREM UT
84097-7817
US

V. Phone/Fax

Practice location:
  • Phone: 385-439-1930
  • Fax:
Mailing address:
  • Phone: 385-439-1930
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: