MARYANNE MEDINA

Behavior Technician

Active Individual
NPI: 1417736158

Practice Address

780 S GUARDSMAN WAY
Salt Lake City, UT 84108

Phone: (801) 581-0194

Specialties

Specialty Code Primary License
Behavior Technician 106S00000X Yes RBT-25-406398 (UT)

Frequently Asked Questions

NPI 1417736158 is the National Provider Identifier for MARYANNE MEDINA, a Behavior Technician provider located in Salt Lake City, UT. This NPI was enumerated on September 22, 2023.
MARYANNE MEDINA practices at 780 S GUARDSMAN WAY, Salt Lake City, UT 84108.

Quick Facts

NPI
1417736158
Type
Individual
Enumerated
Sep 22, 2023
Last Updated
Jan 27, 2025

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