Provider Demographics
NPI:1932421161
Name:HARVEY, QUINTEN J (PHD)
Entity Type:Individual
Prefix:MR
First Name:QUINTEN
Middle Name:J
Last Name:HARVEY
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 1:4164 OPEN CREST DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-7701
Mailing Address - Country:US
Mailing Address - Phone:801-979-0976
Mailing Address - Fax:801-820-8234
Practice Address - Street 1:4164 OPEN CREST DR
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095-7701
Practice Address - Country:US
Practice Address - Phone:801-979-0976
Practice Address - Fax:801-820-8234
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-15
Last Update Date:2010-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5180145-2501103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent