Shane Byron Park

NPI #1265850143 in West Jordan, Utah

Provider Information

NPI Number: 1265850143
Entity Type: Individual
Name: Shane Byron Park
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Analyst
Enumeration Date: Mar 28, 2014
Last Updated: Mar 28, 2014

Practice Location

Address: 5500 W BAGLEY PARK RD
City: West Jordan
State: Utah
ZIP Code: 84081-5697
Phone: (702) 917-4192

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Analyst	103K00000X	Primary

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