Healthcare Provider Details

I. General information

NPI: 1770941296
Provider Name (Legal Business Name): HILLARY KAY JENSON BCBA, LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2016
Last Update Date: 08/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

448 E WINCHESTER ST STE 200
SALT LAKE CITY UT
84107-8525
US

IV. Provider business mailing address

1443 W 800 N #103
OREM UT
84057-2875
US

V. Phone/Fax

Practice location:
  • Phone: 801-280-0413
  • Fax:
Mailing address:
  • Phone: 801-655-4950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number11354806-2506
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: