Individual
DR. THOMAS E. ATKIN PSY.D.D.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICENSED CLINICAL PS
Contact information
Practice address
545 WEST 465 NORTH, STE. #130, PROVIDENCE, UT 84332
(435) 792-0355
(435) 792-3630
Mailing address
PO. BOX #6427, LOGAN, UT 84341
(435) 792-0355
(435) 792-3630
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
113531-2501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
660600550029
—
UT
01
—
CAGH11411306
CAQH #
UT
Enumeration date
01/18/2007
Last updated
10/06/2011
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