Individual
TILLY DOWNER
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
(800) 434-8923
Mailing address
515 S 700 E STE 2A, SALT LAKE CITY, UT 84102-2855
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
11368810-2507
UT
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1396085718
—
UT
Enumeration date
10/26/2016
Last updated
07/09/2019
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