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Organization
PINEBROOK MENTAL HEALTH THERAPY INC.
Active
Organization
PINEBROOK MENTAL HEALTH THERAPY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACQUELINE HYDE PSYD, CMHC (CEO)
(435) 562-1903
Entity
Organization
Contact information
Practice address
3100 PINEBROOK RD STE 1250B, PARK CITY, UT 84098-5663
(435) 562-1903
Mailing address
3100 PINEBROOK RD STE 1250B, PARK CITY, UT 84098-5663
(435) 562-1903
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
NULL
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/23/2024
Last updated
12/22/2024
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