Individual
JEREMY AUSTIN CHILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1306 DEER CREST CIR, FRUIT HEIGHTS, UT 84037-3204
(801) 643-2536
(801) 451-0539
Mailing address
1306 DEER CREST CIR, FRUIT HEIGHTS, UT 84037-3204
(801) 643-2536
(801) 451-0539
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
376639-2501
UT
Other
Enumeration date
04/23/2010
Last updated
04/23/2010
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