Provider Demographics
NPI:1225426786
Name:TRIBBLE, ALAN LEE
Entity Type:Individual
Prefix:MR
First Name:ALAN
Middle Name:LEE
Last Name:TRIBBLE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3274 E OAKCLIFF DR
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84124-5660
Mailing Address - Country:US
Mailing Address - Phone:801-696-7319
Mailing Address - Fax:801-272-7003
Practice Address - Street 1:3274 E OAKCLIFF DR
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84124
Practice Address - Country:US
Practice Address - Phone:801-696-7319
Practice Address - Fax:801-272-7003
Is Sole Proprietor?:No
Enumeration Date:2015-01-06
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1-00-0069OtherBEHAVIOR ANALYST CERTIFICATION BOARD