Provider Demographics
NPI:1932495850
Name:NADALSKY, MICHELLE (BCBA, LBA, SSW)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:NADALSKY
Suffix:
Gender:F
Credentials:BCBA, LBA, SSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3196 S 3210 E
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-1784
Mailing Address - Country:US
Mailing Address - Phone:435-200-9949
Mailing Address - Fax:435-201-6080
Practice Address - Street 1:3196 S 3210 E
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-1784
Practice Address - Country:US
Practice Address - Phone:435-261-3118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-20
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9210307-2506103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst