# UTAH AUTISM ACADEMY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164815999
- **Authorized official:** TRICIA NELSON (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (801) 906-1553

## Contact information

- **Practice address:** 7434 S STATE ST, MIDVALE, UT 84047-2014
- **Practice address phone:** (801) 456-9955
- **Mailing address:** 7434 S STATE ST, MIDVALE, UT 84047-2014
- **Mailing address phone:** (801) 456-9955

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225X00000X | Occupational Therapist | 8050057-4201 | UT | Yes |

## Other

- **Enumeration date:** 03/18/2015
- **Last updated:** 03/18/2015