Provider Demographics
NPI:1619298783
Name:UTAH PSYCHOLOGICAL SERVICES, PLLC
Entity type:Organization
Organization Name:UTAH PSYCHOLOGICAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SUPERVISOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:ALICIA
Authorized Official - Last Name:MONEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:801-368-2278
Mailing Address - Street 1:1453 N 1200 W
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-2449
Mailing Address - Country:US
Mailing Address - Phone:801-368-2278
Mailing Address - Fax:801-734-4946
Practice Address - Street 1:1453 N 1200 W
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-2449
Practice Address - Country:US
Practice Address - Phone:801-734-4945
Practice Address - Fax:801-805-2655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-11
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health