Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | ||
N | 106E00000X | Assistant Behavior Analyst | 0-19-10435 | UT |
N | 106E00000X | Assistant Behavior Analyst | 11608862-2507 | UT |
N | 106S00000X | Behavior Technician |
NPI | 1093209934 |
---|---|
Provider Name | Haley Brooke Shields |
First Address | West Jordan, UT 84088-6337 |
Second Address | West Jordan, UT 84088-6337 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2018 |
Last Update Date | 29/07/2021 |