Dajaria Conway

Individual provider Active NPI Behavior Technician · South Salt Lake, UT

NPI 1962261867 · NPPES record last updated Mar 14, 2024

Key facts

NPI
1962261867
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
2480 S Main St # 206
South Salt Lake, UT 84115-3058
Phone
(801) 644-8544
NPI assigned
Mar 14, 2024
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)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

2480 S Main St # 206
South Salt Lake, UT 84115-3058

Mailing address

2480 S Main St # 206
South Salt Lake, UT 84115-3058
Phone (801) 644-8544

Other providers in South Salt Lake, UT

All providers in South Salt Lake, UT · Behavior Technician in Utah

Sources for this page

Verify at the official NPI Registry.