Provider Demographics
NPI:1801681937
Name:DIONNE, KAITLYN JO (BCBA, LBA)
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:JO
Last Name:DIONNE
Suffix:
Gender:
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4861 W SUMMERFIELD DR
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:UT
Mailing Address - Zip Code:84003-8984
Mailing Address - Country:US
Mailing Address - Phone:435-999-9256
Mailing Address - Fax:
Practice Address - Street 1:10404 S 1055 W
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095-1514
Practice Address - Country:US
Practice Address - Phone:801-855-9110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-10
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT14212871-2506103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst