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Organization
SOUTH DAVIS PSYCHOLOGICAL SERVICES
Active
Organization
SOUTH DAVIS PSYCHOLOGICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN AHERN PH.D. (OWNER)
(801) 934-3373
Entity
Organization
Contact information
Practice address
520 N MARKET PLACE DR STE 200, CENTERVILLE, UT 84014-4904
(801) 934-3373
Mailing address
520 N MARKET PLACE DR STE 200, CENTERVILLE, UT 84014-4904
(801) 934-3373
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437400447
—
UT
Enumeration date
01/24/2018
Last updated
09/07/2022
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