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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

Other

Enumeration date
10/23/2024
Last updated
12/22/2024
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