Provider Demographics
NPI:1912323411
Name:FORSYTHE, NAVINA (PHD)
Entity Type:Individual
Prefix:DR
First Name:NAVINA
Middle Name:
Last Name:FORSYTHE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12215 S HIDDEN VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84092-5936
Mailing Address - Country:US
Mailing Address - Phone:801-597-0120
Mailing Address - Fax:
Practice Address - Street 1:12215 S HIDDEN VALLEY RD
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84092-5936
Practice Address - Country:US
Practice Address - Phone:801-597-0120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-09
Last Update Date:2024-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT103TC1900X
UT286022-2501103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling