Individual
JACLYN CLAIRE PICKERING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
415 MEDICAL DR STE D101, BOUNTIFUL, UT 84010-8905
(801) 683-1062
Mailing address
415 MEDICAL DR STE D101, BOUNTIFUL, UT 84010-8905
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-42771
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100657000
—
FL
Enumeration date
05/02/2019
Last updated
09/07/2021
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