Individual
DAVID TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
729 S ARAPEEN DR, SALT LAKE CITY, UT 84108-1218
(801) 132-1546
Mailing address
PO BOX 3238, BOSTON, MA 02241-3238
(866) 689-8862
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
286133-2501
UT
103T00000X
Psychologist
PS00895
RI
103TC0700X
Clinical Psychologist
286133-2501
UT
103TC0700X
Clinical Psychologist
36454
TX
Other
Enumeration date
04/20/2006
Last updated
12/16/2021
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