Provider Demographics
NPI:1538800248
Name:LINNELL, NAOMI (BCBA, MS)
Entity type:Individual
Prefix:
First Name:NAOMI
Middle Name:
Last Name:LINNELL
Suffix:
Gender:F
Credentials:BCBA, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2496 W 4700 S
Mailing Address - Street 2:
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84129-1655
Mailing Address - Country:US
Mailing Address - Phone:801-935-4171
Mailing Address - Fax:
Practice Address - Street 1:919 CALLIE CT
Practice Address - Street 2:
Practice Address - City:NORTH SALT LAKE
Practice Address - State:UT
Practice Address - Zip Code:84054-0165
Practice Address - Country:US
Practice Address - Phone:801-923-3537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1-24-74618103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst