# GRACE FORSYTHE PHD INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558430389
- **Authorized official:** DR. GRACE A FORSYTHE PHD, APRN (PRESIDENT)
- **Authorized official phone:** (801) 273-7769

## Contact information

- **Practice address:** 2046 MURRAY HOLLADAY RD, 103, SALT LAKE CITY, UT 84117-5125
- **Practice address phone:** (801) 273-7769
- **Practice address fax:** (801) 273-4073
- **Mailing address:** 4271 NEPTUNE DR, SALT LAKE CITY, UT 84124-3362
- **Mailing address phone:** (801) 273-7769
- **Mailing address fax:** (801) 273-4073

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 2189134405 | UT | Yes |

## Other

- **Enumeration date:** 11/07/2006
- **Last updated:** 12/31/2010