Individual
VITTAWAT SRIPHONGNGARM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
12637 S 265 W, DRAPER, UT 84020-5400
(801) 998-8428
(801) 407-1611
Mailing address
12637 S 265 W, DRAPER, UT 84020-5400
(801) 998-8428
(801) 407-1611
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-36623
UT
Other
Enumeration date
03/04/2020
Last updated
10/22/2023
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