Individual
NICOLETTE LYNN GOINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
240 MORRIS AVE STE 400, SOUTH SALT LAKE, UT 84115-3295
(801) 587-8020
Mailing address
7901 S CARLY CT, WEST JORDAN, UT 84088-4666
(801) 516-8104
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
11166867-2506
UT
247200000X
Other Technician
—
—
Other
Enumeration date
03/18/2015
Last updated
04/27/2022
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