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NPI Code Detail

MEDICARE: LILITH NOWAK

MEDICARE: LILITH NOWAK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1194684464
Entity Type Code : Individual
Provider Name (Legal Business Name) : LILITH NOWAK
Provider Business Mailing Address
First Line : 1030 CROSS ST
Second Line :
City : OGDEN
State : UT
Zip : 84404-5124
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 12055 S 700 E
Second Line :
City : DRAPER
State : UT
Zip : 84020-9746
Country : US
Telephone Number : 801-980-7970
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/21/2026
Last Update Date : 01/21/2026

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Directions to “ LILITH NOWAK ” Practice Location

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