Individual
MRS. NICOLE WAKEFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., BCBA, LBA
Contact information
Practice address
8031 S 700 E, SANDY, UT 84070-0555
(385) 695-2203
Mailing address
1441 E FT UNION BLVD, COTTONWOOD HEIGHTS, UT 84121-2847
(385) 695-2203
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-49185
UT
106S00000X
Behavior Technician
—
—
Other
Enumeration date
05/23/2018
Last updated
11/27/2023
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