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Individual

ALYSSA CHIDESTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
6033 FASHION POINT DR, SOUTH OGDEN, UT 84403-4847
(801) 549-8821
Mailing address
209 E GORDON AVE, LAYTON, UT 84041-2341
(801) 663-4316
(801) 513-5608

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
12976712-2506
UT
106S00000X
Behavior Technician
UT

Other

Enumeration date
04/23/2020
Last updated
08/30/2022
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