Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 11997268-2506 | UT |
N | 106E00000X | Assistant Behavior Analyst | 11997268-2507 | UT |
N | 106S00000X | Behavior Technician | ||
N | 106S00000X | Behavior Technician | UT | |
N | 106S00000X | Behavior Technician | RBT-18-52417 | UT |
NPI | 1063909307 |
---|---|
Provider Name | Jonathon Thomas |
First Address | West Point, UT 84015-7468 |
Second Address | Salt Lake City, UT 84102-2855 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2018 |
Last Update Date | 29/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
W222530056 | ATENA (01) | UT |