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NPI Code Detail

MEDICARE: SEAN WEEKS

MEDICARE:   SEAN  WEEKS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TS0200XSchool Psychologist13520866-2504UT

General Provider Information

NPI Number : 1225817323
Entity Type Code : Individual
Provider Name (Legal Business Name) : SEAN WEEKS
Provider Business Mailing Address
First Line : 758 S 900 W
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84104-1401
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2530 KEARNS BLVD
Second Line :
City : PARK CITY
State : UT
Zip : 84060-7473
Country : US
Telephone Number : 859-230-7857
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2023
Last Update Date : 12/08/2024

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Directions to “ SEAN WEEKS ” Practice Location

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