Individual
ALEXA ARCHIBALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, BCBA, LBA
Contact information
Practice address
12222 S 1000 E, DRAPER, UT 84020-8278
(435) 754-9003
Mailing address
1795 S LAURELHURST DR, SALT LAKE CITY, UT 84108-3309
(435) 754-9003
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-57443
UT
103K00000X
Behavior Analyst
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12644849-2506
—
UT
Enumeration date
09/05/2018
Last updated
01/10/2022
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