| Advanced Autism Services Ut Llc | |
|
10 W Broadway Fl 7 Salt Lake City UT 84101-2060 | |
| (602) 584-9860 | |
| (602) 715-1135 |
| Full Name | Advanced Autism Services Ut Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 10 W Broadway Fl 7, Salt Lake City, Utah |
| Authorized Official Name and Position | Malkie Hersko (DIRECTOR) |
| Authorized Official Contact | 6025849860 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Autism Services Ut Llc Po Box 1335 Lakewood NJ 08701-1011 Ph: (602) 584-9860 | Advanced Autism Services Ut Llc 10 W Broadway Fl 7 Salt Lake City UT 84101-2060 Ph: (602) 584-9860 |
| NPI Number | 1730937608 |
|---|---|
| Provider Enumeration Date | 05/07/2024 |
| Last Update Date | 05/07/2024 |
| Certification Date | 05/07/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730937608 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 106S00000X | Behavior Technician | (* (Not Available)) | Secondary |
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