Organization
CHILD&FAMILY INSTITUTE FOR ASSESSMENT AND PSYCHOTHERAPY, LLC
Active
Other names
Child & Family Institute, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNIFER SANTOSUSSO GALE PSY.D. (OWNER/PEDIATRIC NEUROPSYCHOLOGIST)
(435) 645-9240
Entity
Organization
Contact information
Practice address
1910 PROSPECTOR AVE, SUITE 201, PARK CITY, UT 84060-7211
(435) 645-9240
(435) 645-9237
Mailing address
1910 PROSPECTOR AVE, SUITE 201, PARK CITY, UT 84060-7211
(435) 645-9240
(435) 645-9237
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
377761-2501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149727806001
—
UT
Enumeration date
03/21/2006
Last updated
08/22/2020
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