Individual
JACQUELINE KAREN CHIPANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
515 S 700 E STE 2A, SALT LAKE CITY, UT 84102-2855
(801) 308-9113
Mailing address
1112 E 400 S, SALT LAKE CITY, UT 84102-3102
(714) 878-1466
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
802022182
SELECT HEALTH
UT
Enumeration date
08/08/2019
Last updated
09/05/2019
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