Individual
JESSIE ROSDAHL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, BCBA, LBA
Contact information
Practice address
7434 S STATE ST, MIDVALE, UT 84047-2014
(801) 456-9955
Mailing address
4001 S 300 E APT 11, SALT LAKE CITY, UT 84107-1606
(801) 822-8452
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-17-25435
UT
106E00000X
Assistant Behavior Analyst
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Other
Enumeration date
12/07/2016
Last updated
06/07/2017
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