Organization
UNIVERSITY OF UTAH PEDIATRIC BEHAVIORAL HEALTH SERVICES
Active
Parent organization
UNIVERSITY OF UTAH PEDIATRIC BEHAVIORAL HEALTH SERVICES
Other names
Pediatric Behavioral Health Outpatient Svcs
Organization subpart
Yes
Provider details
NPI number
Legal business name
UNIVERSITY OF UTAH PEDIATRIC BEHAVIORAL HEALTH SERVICES
Authorized official
EDWARD CLARK MD (DEPARTMENT CHAIR)
(801) 587-6336
Entity
Organization
Contact information
Practice address
501 S CHIPETA WAY, SALT LAKE CITY, UT 84108-1222
(801) 585-1575
Mailing address
PO BOX 413021, SALT LAKE CITY, UT 84141-3021
(801) 213-3900
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
—
—
Other
Enumeration date
10/07/2016
Last updated
10/07/2016
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