Provider Demographics
NPI:1326338732
Name:SNELL PSYCHOLOGICAL SERVICES LLC
Entity Type:Organization
Organization Name:SNELL PSYCHOLOGICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:
Authorized Official - Last Name:SNELL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:801-598-5244
Mailing Address - Street 1:8033 ROYAL LN
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD HEIGHTS
Mailing Address - State:UT
Mailing Address - Zip Code:84093-6429
Mailing Address - Country:US
Mailing Address - Phone:801-598-5244
Mailing Address - Fax:801-501-7317
Practice Address - Street 1:11075 S STATE ST
Practice Address - Street 2:SUITE 28
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84070-5164
Practice Address - Country:US
Practice Address - Phone:801-990-4306
Practice Address - Fax:801-501-7317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-19
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health