Provider Demographics
NPI:1265891790
Name:DUTHRIE, DONNA (RBT)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:DUTHRIE
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1357 W INDIAN HILLS DR UNIT 6
Mailing Address - Street 2:
Mailing Address - City:SAINT GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-1955
Mailing Address - Country:US
Mailing Address - Phone:406-283-1167
Mailing Address - Fax:
Practice Address - Street 1:1357 W INDIAN HILLS DR UNIT 6
Practice Address - Street 2:
Practice Address - City:SAINT GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-1955
Practice Address - Country:US
Practice Address - Phone:406-283-1167
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-11
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UTRBT-15-5602-15805103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst