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Matthew Carlisle

Behavior Technician in Taylorsville, UT. Individual provider (NPI-1).

NPI number1164060901
StatusActive
Last updated in NPPESDec 11, 2019

Details

NPI
1164060901
Entity type
Individual (NPI-1)
Name
Matthew Carlisle
Sex
Male
Sole proprietor
Yes
Enumeration date
Dec 11, 2019
Certification date
Dec 11, 2019
Last updated
Dec 11, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
106S00000X Behavior Technician––Yes

Practice location

6013 S Redwood Rd
Taylorsville, UT 84123-5220

Phone 801-255-5131

Mailing address

6013 S Redwood Rd
Taylorsville, UT 84123-5220

Phone 801-255-5131

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