Derek Dugan, RBT

Individual provider Active NPI Behavior Technician · Riverdale, UT

NPI 1386144459 · NPPES record last updated Feb 15, 2018

Key facts

NPI
1386144459
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
4933 S 1500 W Ste 110
Riverdale, UT 84405-7738
Phone
(801) 820-6420
NPI assigned
Feb 15, 2018
Sex
Male
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
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

4933 S 1500 W Ste 110
Riverdale, UT 84405-7738

Mailing address

1443 W 800 N Ste 103
Orem, UT 84057-2878
Phone (801) 655-4950

Other providers in Riverdale, UT

All providers in Riverdale, UT · Behavior Technician in Utah

Sources for this page

Verify at the official NPI Registry.