Provider Demographics
NPI:1598546970
Name:BHOWMICK, CHLOE PRIYA RAE (PHD)
Entity Type:Individual
Prefix:
First Name:CHLOE
Middle Name:PRIYA RAE
Last Name:BHOWMICK
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 1:7650 S EURO DR APT B206
Mailing Address - Street 2:
Mailing Address - City:MIDVALE
Mailing Address - State:UT
Mailing Address - Zip Code:84047-5057
Mailing Address - Country:US
Mailing Address - Phone:408-644-7375
Mailing Address - Fax:
Practice Address - Street 1:1291 W 12600 S STE 102
Practice Address - Street 2:
Practice Address - City:RIVERTON
Practice Address - State:UT
Practice Address - Zip Code:84065-7130
Practice Address - Country:US
Practice Address - Phone:801-272-5083
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11998626-2501103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical