| Autism Team | |
|
3909 E Cardon Ln Unit 2 Eagle Mountain UT 84005-4970 | |
| (949) 767-7196 | |
| Not Available |
| Full Name | Autism Team |
|---|---|
| Speciality | Behavior Analyst |
| Location | 3909 E Cardon Ln Unit 2, Eagle Mountain, Utah |
| Authorized Official Name and Position | Krystal L Potter (AUTISM TEAM OWNER) |
| Authorized Official Contact | 9497677196 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Autism Team 3909 E Cardon Ln Unit 2 Eagle Mountain UT 84005-4970 Ph: (949) 767-7196 | Autism Team 3909 E Cardon Ln Unit 2 Eagle Mountain UT 84005-4970 Ph: (949) 767-7196 |
| NPI Number | 1033863808 |
|---|---|
| Provider Enumeration Date | 02/09/2022 |
| Last Update Date | 02/11/2022 |
| Certification Date | 02/11/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033863808 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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