Gregory Avalos

Individual provider Active NPI Behavior Technician · Cedar City, UT

NPI 1821722463 · NPPES record last updated Jul 11, 2022

Key facts

NPI
1821722463
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
1870 N Main St Ste 206
Cedar City, UT 84721-7741
Phone
(801) 255-5131
NPI assigned
Jul 11, 2022
Sex
Male
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)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

1870 N Main St Ste 206
Cedar City, UT 84721-7741

Mailing address

6013 S Redwood Rd
Taylorsville, UT 84123-5220

Other identifiers

IdentifierTypeStateIssuer
1104119619OtherUTBEHAVIOR TECH

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address credentialing@utbs.co

Other providers in Cedar City, UT

All providers in Cedar City, UT · Behavior Technician in Utah

Sources for this page

Verify at the official NPI Registry.