Individual
MRS. NICOLE HAZELTON MATTHEWS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED, BCBA
Contact information
Practice address
7434 S. STATE ST., MIDVALE, UT 84047
(801) 456-9955
(801) 456-9954
Mailing address
7434 SOUTH STATE STREET, MIDVALE, UT 84047
(801) 456-9955
(801) 456-9954
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-11-8121
—
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
05/01/2011
Last updated
10/07/2014
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