Healthcare Provider Details

I. General information

NPI: 1801324058
Provider Name (Legal Business Name): MORGAN GABRIELLE SCHROEDER PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MORGAN GABRIELLE MCCARGO PH.D.

II. Dates (important events)

Enumeration Date: 06/01/2017
Last Update Date: 03/22/2022
Certification Date: 03/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12176 S 1000 E STE 12
DRAPER UT
84020-3221
US

IV. Provider business mailing address

12176 S 1000 E STE 12
DRAPER UT
84020-3221
US

V. Phone/Fax

Practice location:
  • Phone: 801-613-9184
  • Fax:
Mailing address:
  • Phone: 801-613-9184
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number12497106-2501
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: