Most Relevant Information
Provider Data
| NPI Number: | 1003598988 |
| Provider Name: | STACEY MEDLEY |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/01/2023 |
| Last Updated: | 08/01/2023 |
Provider Practice Location
475 W 260 N
OREM
UT
840571970
Practice Location Phone/Fax
| Phone: | 8012219930 |
| Fax: |
Provider Mailing Location
475 W 260 N
OREM
UT
840571970
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |