Individual
SHANE D. STOWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
412 W 800 N, OREM, UT 84057-3728
(801) 235-7246
Mailing address
283 E 930 S, OREM, UT 84058-5001
(801) 225-6246
(801) 225-1525
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
7369628-2501-2501
UT
103TA0400X
Addiction (Substance Use Disorder) Psychologist
7369628-2501
UT
103TC0700X
Clinical Psychologist
7369628-2501
UT
103TC1900X
Counseling Psychologist
7369628-2501
UT
103TH0100X
Health Service Psychologist
2369628-2501
UT
Other
Enumeration date
03/12/2010
Last updated
03/12/2010
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