Provider Demographics
NPI:1164540472
Name:CHAPPUIS, MARCEL C (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARCEL
Middle Name:C
Last Name:CHAPPUIS
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 1:850 DONNER WAY APT 504
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84108-2133
Mailing Address - Country:US
Mailing Address - Phone:801-560-5863
Mailing Address - Fax:801-533-5666
Practice Address - Street 1:6129 ELSIE CT
Practice Address - Street 2:
Practice Address - City:TAYLORSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84123-5369
Practice Address - Country:US
Practice Address - Phone:801-261-4771
Practice Address - Fax:801-261-4778
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT111619-2501103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical