Madivel Raddon
Individual provider Active NPI Behavior Technician · Draper, UT
NPI 1184378481 · NPPES record last updated Feb 7, 2022
Key facts
- NPI
- 1184378481
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 12222 S 1000 E
Draper, UT 84020-8278 - Phone
- (801) 987-3592
- NPI assigned
- Feb 7, 2022
- Sex
- Female
- Sole proprietor
- Yes
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
12222 S 1000 E
Draper, UT 84020-8278
Mailing address
12222 S 1000 E
Draper, UT 84020-8278
Phone (801) 987-3592
Other providers in Draper, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 7, 2022. 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.