Individual
ALISA STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
4905 S 1500 W # 110, RIVERDALE, UT 84405-7176
(801) 900-2440
Mailing address
1443 W 800 N STE 103, OREM, UT 84057-2878
(801) 655-4950
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-16-25600
UT
Other
Enumeration date
11/30/2016
Last updated
11/30/2016
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