Derek R Ellsworth
Derek R Ellsworth is a Behavior Technician in Salt Lake City, Utah. Licensed in Utah. Registered with an NPI since 2021.
- Licensed in
- UT
- In the registry since
- 2021
Practice location Address checks out
515 S 700 E Ste 2ASalt Lake City, UT 84102-2855
Phone: (801) 935-4171
Fax: (801) 935-4946
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Behavior Technician (primary) | Taxonomy 106S00000X (UT) |
|---|
Record details
| NPI number | 1386219301 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | May 21, 2021 |
| Last updated in NPPES | May 21, 2021 |
| Certification date | May 21, 2021 |
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