Individual
MADISON HADDOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12637 S 265 W STE 300, DRAPER, UT 84020-5403
(801) 998-8428
Mailing address
12637 S 265 W STE 300, DRAPER, UT 84020-5403
(801) 987-3592
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
128621782506
UT
106S00000X
Behavior Technician
—
—
Other
Enumeration date
01/06/2020
Last updated
07/28/2022
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