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General NPI Number Information
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NPI Number | 1639078959
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Entity Type | Individual
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Provider Name | KASIAH BALLARD RBT
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Gender | Female
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Dates
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Enumeration Date | 11/03/2026
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Last Update Date | 11/03/2026
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Provider Practice Location Address
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Address Line | 12055 S 700 E
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City | DRAPER
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State | UT
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Zip | 84020-9746
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Country | US
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Telephone | 801-980-7970
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Fax | 801-852-0436
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Provider Business Mailing Address
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Address Line | 95 E 2200 S
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City | BOUNTIFUL
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State | UT
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Zip | 84010-5619
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Country | US
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Telephone | 801-980-7970
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Fax | 801-852-0436
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-26-2865496
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License Number State | UT
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