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8811 S Sandy Pkwy #100 Sandy UT 84070 | |
| (561) 866-2097 | |
| (754) 600-1967 |
| Full Name | |
|---|---|
| Speciality | Behavior Analyst |
| Location | 8811 S Sandy Pkwy, Sandy, Utah |
| Authorized Official Name and Position | Cecilia Martinez (BILLING MANAGER) |
| Authorized Official Contact | 5617707121 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1239 E Newport Center Dr Deerfield Beach FL 33442-7711 Ph: (754) 444-3707 | 8811 S Sandy Pkwy #100 Sandy UT 84070 Ph: (561) 866-2097 |
| NPI Number | 1093597726 |
|---|---|
| Provider Enumeration Date | 10/17/2023 |
| Last Update Date | 12/23/2024 |
| Certification Date | 12/18/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093597726 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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