Provider Demographics
NPI:1245437235
Name:UTAH PSYCHOLOGICAL CENTER INC.
Entity type:Organization
Organization Name:UTAH PSYCHOLOGICAL CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:T
Authorized Official - Last Name:LIEBRODER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:801-263-0800
Mailing Address - Street 1:3970 S 700 E STE 12
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-2584
Mailing Address - Country:US
Mailing Address - Phone:801-263-0800
Mailing Address - Fax:801-263-0901
Practice Address - Street 1:3970 S 700 E STE 12
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84107-2584
Practice Address - Country:US
Practice Address - Phone:801-263-0800
Practice Address - Fax:801-263-0901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT108503-2501103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty