Provider Demographics
NPI:1932076742
Name:AUSTEN, GRAHAM ASHLEY
Entity type:Individual
Prefix:
First Name:GRAHAM
Middle Name:ASHLEY
Last Name:AUSTEN
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 1:3179 W PRAIRIE GRASS DR
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84048-5950
Mailing Address - Country:US
Mailing Address - Phone:818-264-8714
Mailing Address - Fax:
Practice Address - Street 1:3179 W PRAIRIE GRASS DR
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84048-5950
Practice Address - Country:US
Practice Address - Phone:818-264-8714
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-17
Last Update Date:2025-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UTRBT-25-411607106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician