Provider Demographics
NPI:1720821101
Name:ARAGON, GABRIELA (MT-BC)
Entity type:Individual
Prefix:
First Name:GABRIELA
Middle Name:
Last Name:ARAGON
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10876 S WEISS DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84009-7748
Mailing Address - Country:US
Mailing Address - Phone:385-542-0552
Mailing Address - Fax:
Practice Address - Street 1:10876 S WEISS DR
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84009-7748
Practice Address - Country:US
Practice Address - Phone:385-542-0552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-14
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13835921-4010225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist