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Organization
ADVANCED AUTISM SERVICES UT LLC
Active
Organization
ADVANCED AUTISM SERVICES UT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MALKIE HERSKO MS CCC SLP (DIRECTOR)
(602) 584-9860
Entity
Organization
Contact information
Practice address
10 W BROADWAY FL 7, SALT LAKE CITY, UT 84101-2060
(602) 584-9860
(602) 715-1135
Mailing address
PO BOX 1335, LAKEWOOD, NJ 08701-1011
(602) 584-9860
(602) 715-1135
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
05/07/2024
Last updated
05/07/2024
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