Individual
MCKENZIE NIEBERGALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCABA
Contact information
Practice address
881 W BAXTER DR STE 100, SOUTH JORDAN, UT 84095-8506
(877) 565-7169
(703) 348-3267
Mailing address
658 E 600 N APT 11, LOGAN, UT 84321-3555
(801) 865-0668
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
0-23-14822
UT
Other
Enumeration date
02/20/2024
Last updated
02/20/2024
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