MEDICARE: KALEY ELIZABETH RALEIGH MS., BCBA, LBA

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
1	103K00000X	Behavior Analyst	14205408-2506	UT

General Provider Information

NPI Number	:	1386103430
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KALEY ELIZABETH RALEIGH MS., BCBA, LBA

Provider Business Mailing Address
First Line	:	1240 E STRINGHAM AVE RM 2
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84106-2560
Country	:	US
Telephone Number	:	801-214-1115
Fax Number	:	801-340-2115

Provider Business Practice Location Address
First Line	:	1240 E STRINGHAM AVE RM 2
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84106-2560
Country	:	US
Telephone Number	:	801-214-1115
Fax Number	:	801-340-2115

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/18/2019
Last Update Date	:	02/25/2026

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