Provider Demographics
NPI:1649618315
Name:BALMER, JARED U (PHD)
Entity type:Individual
Prefix:
First Name:JARED
Middle Name:U
Last Name:BALMER
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:PO BOX 488
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84317-0488
Mailing Address - Country:US
Mailing Address - Phone:801-690-7000
Mailing Address - Fax:801-917-6034
Practice Address - Street 1:9091 E 100 S
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84317-9608
Practice Address - Country:US
Practice Address - Phone:801-690-7000
Practice Address - Fax:801-917-6034
Is Sole Proprietor?:No
Enumeration Date:2013-06-04
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)