Kylee Ackman
Individual provider Active NPI Behavior Technician · Orem, UT
NPI 1104606185 · NPPES record last updated Oct 5, 2023
Key facts
- NPI
- 1104606185
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 1140 W 1130 S
Building B20
Orem, UT 84058 - Phone
- (801) 935-4171
- NPI assigned
- Oct 5, 2023
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
1140 W 1130 S
Building B20
Orem, UT 84058
Mailing address
16255 Ventura Blvd Ste 830
Encino, CA 91436-2317
Other providers in Orem, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 5, 2023. 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.