Provider Demographics
NPI:1760843643
Name:NEWMAN, FELICIA MCCLEERY
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:MCCLEERY
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:FELICIA
Other - Middle Name:DAWN
Other - Last Name:MCCLEERY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:3171 N 3450 W
Mailing Address - Street 2:
Mailing Address - City:PLAIN CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84404-6790
Mailing Address - Country:US
Mailing Address - Phone:435-994-4704
Mailing Address - Fax:
Practice Address - Street 1:2940 N CHURCH ST STE 303
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84040-6617
Practice Address - Country:US
Practice Address - Phone:435-994-4704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-18
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9623623-2506103K00000X
RBT-16-20218106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician