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General NPI Number Information
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NPI Number | 1679486419
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Entity Type | Individual
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Provider Name | KATERINA BRISCOE
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Gender | Female
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Dates
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Enumeration Date | 09/23/2026
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Last Update Date | 09/23/2026
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Provider Practice Location Address
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Address Line | 430 W 810 N
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City | LOGAN
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State | UT
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Zip | 84321-5753
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Country | US
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Telephone | 801-686-7860
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Fax |
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Provider Business Mailing Address
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Address Line | 2111 E GREATBLACK CIR
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City | LAYTON
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State | UT
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Zip | 84040-4909
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Country | US
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Telephone | 801-200-0819
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Fax |
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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 |
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License Number State | UT
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