Provider Demographics
NPI:1336313618
Name:PRITT., THOMAS E (PHD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:E
Last Name:PRITT.
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 1:690 EAST CENTER ST.
Mailing Address - Street 2:ASSOCIATION FOR PERSONAL DEVELOPMENT
Mailing Address - City:KAYSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84037
Mailing Address - Country:US
Mailing Address - Phone:801-544-1166
Mailing Address - Fax:801-544-6558
Practice Address - Street 1:475 N 300 W
Practice Address - Street 2:SUITE 14
Practice Address - City:KAYSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84037-3125
Practice Address - Country:US
Practice Address - Phone:801-529-7982
Practice Address - Fax:801-544-6558
Is Sole Proprietor?:No
Enumeration Date:2008-04-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT107840-2501103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist