Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1104321215 |
---|---|
Provider Name | Kaitlin Renee Gappmayer |
First Address | Salt Lake City, UT 84124-3543 |
Second Address | Salt Lake City, UT 84124-3543 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2018 |
Last Update Date | 29/03/2018 |