Individual
JORDAN CHAMBERLAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, BCBA
Contact information
Practice address
222 COUNTRYSIDE CIR, PARK CITY, UT 84098-6101
(801) 618-6864
Mailing address
222 COUNTRYSIDE CIR, PARK CITY, UT 84098-6101
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-29457
UT
Other
Enumeration date
09/07/2018
Last updated
09/07/2018
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