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Intermountain Psychology LLC

Clinic/Center, Adult Mental Health in Ogden, UT. Organization (NPI-2).

NPI number1174852289
StatusActive
Last updated in NPPESMar 16, 2010

Details

NPI
1174852289
Entity type
Organization (NPI-2)
Legal business name
Intermountain Psychology LLC
Organization subpart
No
Enumeration date
Dec 18, 2009
Last updated
Mar 16, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QM0850X Clinic/Center, Adult Mental Health––Yes

Practice location

3544 Lincoln Ave
Suite C
Ogden, UT 84401-4045

Phone 801-913-0098 · Fax 801-272-3857

Mailing address

Po Box 17586
Salt Lake City, UT 84117-0586

Phone 801-913-0098 · Fax 801-272-3857

Authorized official

Randy Lynn Ryan
Registered Agent
8019130098

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