Jennifer Burnazos, RBT
Individual provider Active NPI Behavior Analyst · South Ogden, UT
NPI 1083074777 · NPPES record last updated Feb 24, 2016
Key facts
- NPI
- 1083074777
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- License
- RBT-15-04921 (UT)
- Practice address
- 5160 Sunset LN
South Ogden, UT 84403-4230 - Phone
- (801) 935-5796
- NPI assigned
- Feb 24, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-15-04921 | UT | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Applied Behavior Connections LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | RBT-15-04921 | UT | Yes |
Addresses
Primary practice location
5160 Sunset LN
South Ogden, UT 84403-4230
Mailing address
5160 Sunset LN
South Ogden, UT 84403-4230
Phone (801) 935-5796
Other providers in South Ogden, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 24, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.