Individual
AMANDA MAKONI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5331 W IMPRESSIONS WAY, KEARNS, UT 84118-8533
(801) 856-6081
Mailing address
5331 W IMPRESSIONS WAY, KEARNS, UT 84118-8533
(801) 608-9706
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
172A00000X
Driver
—
—
175T00000X
Peer Specialist
—
—
Other
Enumeration date
03/07/2016
Last updated
09/03/2020
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