Melissa Retallick
Behavior Technician in Murray, UT. Individual provider (NPI-1).
NPI number1962029322
StatusActive
Last updated in NPPESOct 28, 2024
Details
- NPI
- 1962029322
- Entity type
- Individual (NPI-1)
- Name
- Melissa Retallick
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 1, 2020
- Certification date
- Oct 28, 2024
- Last updated
- Oct 28, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
404 E 4500 S Ste A34Murray, UT 84107-2710
Phone 801-771-0273 · Fax 801-771-0221
Mailing address
782 Sage DrMorgan, UT 84050-8714
Phone 385-439-9730
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