=====================================================
General NPI Number Information
=====================================================
NPI Number | 1619889367
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | OPEN DOOR AUTISM SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/18/2026
-----------------------------------------------------
Last Update Date | 09/18/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8177 S HIGH SUMMIT CIR
-----------------------------------------------------
City | WEST JORDAN
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84088-5936
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 801-410-0322
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8177 S HIGH SUMMIT CIR
-----------------------------------------------------
City | WEST JORDAN
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84088-5936
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 801-410-0322
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | FOUNDER
-----------------------------------------------------
Name | KAILEE WELLS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 801-819-9862
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TC0700X
-----------------------------------------------------
Taxonomy Name | Clinical Psychologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------