Provider Demographics
NPI:1457420531
Name:A. LYNN SCORESBY & ASSOCIATES
Entity Type:Organization
Organization Name:A. LYNN SCORESBY & ASSOCIATES
Other - Org Name:CHILD & FAMILY PSYCHOLOGIST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:F
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:801-225-9522
Mailing Address - Street 1:703 S STATE ST
Mailing Address - Street 2:SUITE #1
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84058-6326
Mailing Address - Country:US
Mailing Address - Phone:801-225-9522
Mailing Address - Fax:801-225-9498
Practice Address - Street 1:703 S STATE ST
Practice Address - Street 2:SUITE #1
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84058-6326
Practice Address - Country:US
Practice Address - Phone:801-225-9522
Practice Address - Fax:801-225-9498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty