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Organization
AUTISM CELEBRATIONS, LLC
Active
Organization
AUTISM CELEBRATIONS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIRELLA PETERSEN DHA, MISM (OWNER / EXECUTIVE DIRECTOR)
(801) 635-0337
Entity
Organization
Contact information
Practice address
240 N EAST PROMONTORY STE 200, FARMINGTON, UT 84025-2950
(801) 635-0337
Mailing address
2211 FIELD STONE WAY, LAYTON, UT 84041-5532
(801) 635-0337
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
Primary
—
—
103T00000X
Psychologist
—
—
106E00000X
Assistant Behavior Analyst
—
—
2355S0801X
Speech-Language Assistant
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
03/28/2024
Last updated
04/02/2024
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