Jordan Lynn Bale
Individual provider Active NPI Behavior Technician · Herriman, UT
NPI 1790293306 · NPPES record last updated Jan 17, 2018
Key facts
- NPI
- 1790293306
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 13947 S Newburg Dr
Herriman, UT 84096-6787 - Phone
- (801) 506-6695
- NPI assigned
- Jan 17, 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 |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | |||
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
13947 S Newburg Dr
Herriman, UT 84096-6787
Mailing address
13947 S Newburg Dr
Herriman, UT 84096-6787
Other providers in Herriman, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 17, 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.