Individual
HALEY BROOKE SHIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4098 W TETON ESTATES DR, WEST JORDAN, UT 84088-6337
(801) 560-2551
Mailing address
4098 W TETON ESTATES DR, WEST JORDAN, UT 84088-6337
(801) 560-2551
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106E00000X
Assistant Behavior Analyst
0-19-10435
UT
106E00000X
Assistant Behavior Analyst
11608862-2507
UT
106S00000X
Behavior Technician
—
—
Other
Enumeration date
06/14/2018
Last updated
07/29/2021
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