NPI 1023263191

Professional Clinical Management

Organisation Psychologist Provo, UT

Practice location

Address: 1355 N University Ave STE 200, Provo, UT 84604-2721
Phone: (801) 221-0223
Fax: (801) 221-0291

Authorised official

Name: Randall F Hyde
Title: Clinical Director
Phone: (801) 221-0223

Registered specialties

Psychologist Primary

Behavioral Health & Social Service Providers Taxonomy 103T00000X Licence 851131532501 (UT)

Other Psychologist providers in Utah →

Registry record

NPI: 1023263191
Entity type: Organization
NPI issued: 17 Nov 2008
Record last updated: 17 Nov 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.