Provider Demographics
NPI:1982910212
Name:KEDDINGTON, DAVID EMERSON
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:EMERSON
Last Name:KEDDINGTON
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 1:9979 YORKSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-9132
Mailing Address - Country:US
Mailing Address - Phone:801-604-7361
Mailing Address - Fax:
Practice Address - Street 1:9979 YORKSHIRE DR
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095-9132
Practice Address - Country:US
Practice Address - Phone:801-604-7361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-24
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst