Healthcare Provider Details

I. General information

NPI: 1083846810
Provider Name (Legal Business Name): CHRIS ROBERT HUGHES PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2009
Last Update Date: 08/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 N MEADOWBROOK DR
ALPINE UT
84004-1775
US

IV. Provider business mailing address

110 N MEADOWBROOK DR
ALPINE UT
84004-1775
US

V. Phone/Fax

Practice location:
  • Phone: 801-995-5180
  • Fax:
Mailing address:
  • Phone: 801-995-5180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number370989-2501
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number370989-2501
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number370989-2501
License Number StateUT
# 4
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number370989-2501
License Number StateUT
# 5
Primary TaxonomyN
Taxonomy Code103TE1100X
TaxonomyExercise & Sports Psychologist
License Number370989-2501
License Number StateUT
# 6
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number370989-2501
License Number StateUT
# 7
Primary TaxonomyN
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License Number370989-2501
License Number StateUT
# 8
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number370989-2501
License Number StateUT
# 9
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number370989-2501
License Number StateUT
# 10
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number370989-2501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: