Organization
UTAH CENTER FOR EVIDENCE BASED TREATMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBIN ELENA LANGE PH.D. (MEMBER)
(301) 437-1381
Entity
Organization
Contact information
Practice address
164 S 900 E, SALT LAKE CITY, UT 84102-4103
(301) 437-1381
Mailing address
164 S 900 E, SALT LAKE CITY, UT 84102-4103
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LIC201303289
UT
Other
Enumeration date
09/13/2013
Last updated
09/13/2013
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