Anderson, Lacey
Anderson, Lacey is an sole proprietor health care provider with primary practice located at 4058 W Shady Plum Way , South Jordan UT 84095-3908. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavioral Analyst, which is considered as her primary health care specialty. Anderson, Lacey can be contacted via phone (801) 735-3252.Contact Information
Primary practice address
4058 W Shady Plum Way
South Jordan UT 84095-3908
Phone: (801) 735-3252
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Behavioral Analyst | 103K00000X | 11312885 | Utah |
Profile Details
| NPI number | 1609290154 |
|---|---|
| LBN Legal business name | Anderson, Lacey |
| Credentials | BCBA |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 4th, 2014 |
| Last updated | Feb 4th, 2014 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1609290154 | NPPES |
| Utah | MEDICAID | 271872788003 |
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