Madison Jo Hirschi

Individual provider Active NPI Behavior Technician · Pleasant Grove, UT

NPI 1003482191 · NPPES record last updated May 31, 2021

Key facts

NPI
1003482191
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
533 W State Rd Ste 103
Pleasant Grove, UT 84062-2114
Phone
(801) 506-6695
NPI assigned
May 31, 2021
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

533 W State Rd Ste 103
Pleasant Grove, UT 84062-2114

Mailing address

533 W State Rd Ste 103
Pleasant Grove, UT 84062-2114

Other providers in Pleasant Grove, UT

All providers in Pleasant Grove, UT · Behavior Technician in Utah

Sources for this page

Verify at the official NPI Registry.