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General NPI Number Information
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NPI Number | 1083461925
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Entity Type | Organization
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Legal Business Name | UTAH APPLIED BEHAVIOR ANALYSIS
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Dates
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Enumeration Date | 04/30/2024
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Last Update Date | 04/30/2024
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Provider Practice Location Address
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Address Line | 79 N MAPLE LEAF DR
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City | SPANISH FORK
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State | UT
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Zip | 84660-6145
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Country | US
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Telephone | 619-787-3882
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Fax |
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Provider Business Mailing Address
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Address Line | 223 W COUGAR BLVD STE 412
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City | PROVO
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State | UT
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Zip | 84604-2546
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | KRISTIAN GIORDANO
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Credential |
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Telephone | 619-787-3882
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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