Organization
ADVANCED AUTISM SERVICES UT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MALKIE HERSKO MS CCC SLP (DIRECTOR)
(602) 584-9860
Entity
Organization
Contact information
Practice address
10 W BROADWAY FL 7, SALT LAKE CITY, UT 84101-2060
(602) 584-9860
(602) 715-1135
Mailing address
PO BOX 1335, LAKEWOOD, NJ 08701-1011
(602) 584-9860
(602) 715-1135
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
05/07/2024
Last updated
05/07/2024
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