Quort Rawson Staker, BT
Behavior Technician in Salt Lake City, UT. Individual provider (NPI-1).
NPI number1982206868
StatusActive
Last updated in NPPESNov 15, 2020
Details
- NPI
- 1982206868
- Entity type
- Individual (NPI-1)
- Name
- Quort Rawson Staker
- Credential
- BT
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Nov 15, 2020
- Certification date
- Nov 15, 2020
- Last updated
- Nov 15, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
515 S 700 E Ste 2aSalt Lake City, UT 84102-2855
Phone 800-434-8923
Mailing address
515 S 700 E Ste 2aSalt Lake City, UT 84102-2855
Phone 800-434-8923
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