Provider Demographics
NPI:1063652899
Name:SMYTH, PAUL ANTHONY (PHD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:ANTHONY
Last Name:SMYTH
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 1901
Mailing Address - Street 2:418 CLIFFVIEW DR
Mailing Address - City:CASTLE VALLEY
Mailing Address - State:UT
Mailing Address - Zip Code:84532-9611
Mailing Address - Country:US
Mailing Address - Phone:435-259-9484
Mailing Address - Fax:
Practice Address - Street 1:418 CLIFFVIEW DR.
Practice Address - Street 2:
Practice Address - City:CASTLE VALLEY
Practice Address - State:UT
Practice Address - Zip Code:84532-9611
Practice Address - Country:US
Practice Address - Phone:435-259-9484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-06
Last Update Date:2009-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT333582-3902106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist