Provider Demographics
NPI:1689180358
Name:CASPER, NADIA
Entity Type:Individual
Prefix:
First Name:NADIA
Middle Name:
Last Name:CASPER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 E GORDON AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-2375
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:801-513-5608
Practice Address - Street 1:207 E GORDON AVE STE 4
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-2375
Practice Address - Country:US
Practice Address - Phone:801-200-1574
Practice Address - Fax:801-513-5608
Is Sole Proprietor?:No
Enumeration Date:2017-12-18
Last Update Date:2017-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician