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NPI Code Detail

MEDICARE: KADENCE FULKS RBT

MEDICARE:   KADENCE  FULKS  RBT
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 TechnicianRBT-20-143735UT

General Provider Information

NPI Number : 1700464476
Entity Type Code : Individual
Provider Name (Legal Business Name) : KADENCE FULKS RBT
Provider Business Mailing Address
First Line : 3725 W 4100 S STE 201
Second Line :
City : WEST VALLEY CITY
State : UT
Zip : 84120-5411
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6232 S 900 E
Second Line :
City : MURRAY
State : UT
Zip : 84121-2471
Country : US
Telephone Number : 888-949-4864
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2021
Last Update Date : 02/24/2025

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Directions to “ KADENCE FULKS RBT” Practice Location

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