Healthcare Provider Details

I. General information

NPI: 1326663899
Provider Name (Legal Business Name): HANNAH NOEL MELTON BCABA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2020
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

272 N BROADWAY ST
TOOELE UT
84074-2244
US

IV. Provider business mailing address

397 E 740 N
TOOELE UT
84074-3709
US

V. Phone/Fax

Practice location:
  • Phone: 801-755-6277
  • Fax:
Mailing address:
  • Phone: 801-755-6277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-20-122778
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: