Individual
LACHERE FACKRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, BCBA, LBA
Contact information
Practice address
515 S 700 E STE 2A, SALT LAKE CITY, UT 84102-2855
(801) 935-4171
Mailing address
515 S 700 E STE 2A, SALT LAKE CITY, UT 84102-2855
(801) 935-4171
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
10970357-2506
UT
106S00000X
Behavior Technician
—
—
Other
Enumeration date
01/02/2018
Last updated
10/11/2018
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