Provider Demographics
NPI:1558565317
Name:STRASSBERG, DONALD STEPHEN (PHD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:STEPHEN
Last Name:STRASSBERG
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 1:380 S 1530 E RM 502
Mailing Address - Street 2:UNIVERSITY OF UTAH
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84112-0259
Mailing Address - Country:US
Mailing Address - Phone:801-581-7559
Mailing Address - Fax:801-581-5841
Practice Address - Street 1:380 S 1530 E RM 502
Practice Address - Street 2:UNIVERSITY OF UTAH
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84112-0259
Practice Address - Country:US
Practice Address - Phone:801-581-7559
Practice Address - Fax:801-581-5841
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT108230-2501103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist