Healthcare Provider Details
I. General information
NPI: 1407725500
Provider Name (Legal Business Name): POWER ABA OF UTAH LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/05/2025
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9980 S 300 W STE 200
SANDY UT
84070-3654
US
IV. Provider business mailing address
PO BOX 932
TOMS RIVER NJ
08754-0932
US
V. Phone/Fax
- Phone: 732-540-7376
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JAY
HIRTH
Title or Position: COO
Credential:
Phone: 347-971-0039