Provider Demographics
NPI:1174028146
Name:BROWN, HALLEY (PHD)
Entity Type:Individual
Prefix:DR
First Name:HALLEY
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7536 S RUSSI PL
Mailing Address - Street 2:
Mailing Address - City:MIDVALE
Mailing Address - State:UT
Mailing Address - Zip Code:84047-4794
Mailing Address - Country:US
Mailing Address - Phone:520-275-0103
Mailing Address - Fax:
Practice Address - Street 1:248 E 13800 S STE 4
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-5011
Practice Address - Country:US
Practice Address - Phone:801-816-1801
Practice Address - Fax:801-501-0249
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-29
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10526182-2501103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist