Individual
ALLISON IWATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
475 W 260 N, OREM, UT 84057-1970
(801) 221-9930
Mailing address
475 W 260 N, OREM, UT 84057-1970
(801) 221-9930
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-14-17049
UT
Other
Enumeration date
04/21/2015
Last updated
04/21/2015
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