Provider Demographics
NPI:1528191046
Name:SMITH, STEVEN ARTHUR (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:ARTHUR
Last Name:SMITH
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 1:1559 W 1050 N
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-3024
Mailing Address - Country:US
Mailing Address - Phone:801-377-8578
Mailing Address - Fax:
Practice Address - Street 1:1559 W 1050 N
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-3024
Practice Address - Country:US
Practice Address - Phone:801-473-5735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT116068-2501103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist