Healthcare Provider Details

I. General information

NPI: 1669647616
Provider Name (Legal Business Name): CRAIG FREEMAN SPIEL PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2008
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 E MEDICAL TOWER DR
MURRAY UT
84107-4872
US

IV. Provider business mailing address

1205 E PRIVET DRIVE UNIT 1-426
COTTONWOOD HEIGHTS UT
84121
US

V. Phone/Fax

Practice location:
  • Phone: 801-314-4544
  • Fax:
Mailing address:
  • Phone: 740-274-5795
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number10181975-2501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: