Provider Demographics
NPI:1679383178
Name:HOSKISSON, CAMERON KEITH
Entity type:Individual
Prefix:
First Name:CAMERON
Middle Name:KEITH
Last Name:HOSKISSON
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 1:3150 IOWA AVE
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84403-0934
Mailing Address - Country:US
Mailing Address - Phone:801-603-1537
Mailing Address - Fax:801-872-8757
Practice Address - Street 1:2811 N 2350 W
Practice Address - Street 2:
Practice Address - City:FARR WEST
Practice Address - State:UT
Practice Address - Zip Code:84404-5177
Practice Address - Country:US
Practice Address - Phone:801-492-1940
Practice Address - Fax:801-872-8757
Is Sole Proprietor?:No
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician