Shaylee Patricia Moran

Individual provider Active NPI Behavior Technician · Farr West, UT

NPI 1104424993 · NPPES record last updated Oct 13, 2020

Key facts

NPI
1104424993
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
2811 N 2350 W
Farr West, UT 84404-5177
Phone
(801) 452-1940
Fax
(801) 872-8757
NPI assigned
Oct 13, 2020
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Aim-Autism in Motion, Corp Past
since Oct 19, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

2811 N 2350 W
Farr West, UT 84404-5177

Mailing address

2811 N 2350 W
Farr West, UT 84404-5177
Phone (801) 452-1940

Other providers in Farr West, UT

All providers in Farr West, UT · Behavior Technician in Utah

Sources for this page

Verify at the official NPI Registry.