Provider Demographics
NPI:1881351476
Name:CURTIS, BRIAN (PHD)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:CURTIS
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 1:1882 S MOUNTAIN VIEW BLVD # 233
Mailing Address - Street 2:
Mailing Address - City:WOODS CROSS
Mailing Address - State:UT
Mailing Address - Zip Code:84087-2494
Mailing Address - Country:US
Mailing Address - Phone:801-808-7679
Mailing Address - Fax:
Practice Address - Street 1:1882 S MOUNTAIN VIEW BLVD # 233
Practice Address - Street 2:
Practice Address - City:WOODS CROSS
Practice Address - State:UT
Practice Address - Zip Code:84087-2494
Practice Address - Country:US
Practice Address - Phone:385-367-5337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-18
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12431381-2501103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist