Healthcare Provider Details

I. General information

NPI: 1588938120
Provider Name (Legal Business Name): ANNELIESE HANNA SUNSHINE BCBA/LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/29/2012
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9425 S RIVERSIDE DR APT 427
SANDY UT
84070-6521
US

IV. Provider business mailing address

9425 S RIVERSIDE DR APT 427
SANDY UT
84070-6521
US

V. Phone/Fax

Practice location:
  • Phone: 801-602-0892
  • Fax:
Mailing address:
  • Phone: 801-602-0892
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number8446743-2506
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: