Healthcare Provider Details

I. General information

NPI: 1487571642
Provider Name (Legal Business Name): STARLIGHT ABA UT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 E 400 S
SALT LAKE CITY UT
84111-2993
US

IV. Provider business mailing address

350 E 400 S
SALT LAKE CITY UT
84111-2993
US

V. Phone/Fax

Practice location:
  • Phone: 347-454-6140
  • Fax:
Mailing address:
  • Phone: 347-454-6140
  • 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: RAIZEL LEBOVITS
Title or Position: DIRECTOR
Credential:
Phone: 347-454-6140