Kimber Rose Anderson
Individual provider Active NPI Behavior Technician · Orem, UT
NPI 1780182899 · NPPES record last updated Jan 24, 2018
Key facts
- NPI
- 1780182899
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 475 W 260 N
Orem, UT 84057-1970 - Phone
- (801) 221-9930
- NPI assigned
- Jan 24, 2018
- 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 | UT | Yes |
Addresses
Primary practice location
475 W 260 N
Orem, UT 84057-1970
Mailing address
475 W 260 N
Orem, UT 84057-1970
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396085718 | Medicaid | UT |
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 Jan 24, 2018. 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.