Individual
DR. PATRICK THOMAS PANOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
11820 S MAPLE RIDGE CIR, SANDY, UT 84094-7332
(801) 671-5226
Mailing address
11820 S MAPLE RIDGE CIR, SANDY, UT 84094-7332
(801) 671-5226
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
116155-2501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
116155-2501
STATE OF UTAH- PSYCHOLOGY LICENSE NUMBER
UT
Enumeration date
03/22/2021
Last updated
03/22/2021
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