Healthcare Provider Details

I. General information

NPI: 1366372468
Provider Name (Legal Business Name): AVIATION ABA THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1240 E STRINGHAM AVE RM 2
SALT LAKE CITY UT
84106-2560
US

IV. Provider business mailing address

1240 E STRINGHAM AVE RM 2
SALT LAKE CITY UT
84106-2560
US

V. Phone/Fax

Practice location:
  • Phone: 801-214-1115
  • Fax: 801-340-2115
Mailing address:
  • Phone: 801-214-1115
  • Fax: 801-340-2115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: EMILY MARIAH MELLMAN
Title or Position: REGISTERED BEHAVIOR TECHNICIAN
Credential: RBT
Phone: 970-518-1343