Healthcare Provider Details

I. General information

NPI: 1154465813
Provider Name (Legal Business Name): MONICA D CHRISTY PHD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5353 S 960 E SUITE 230
MURRAY UT
84117
US

IV. Provider business mailing address

5353 S 960 E SUITE 230
MURRAY UT
84117
US

V. Phone/Fax

Practice location:
  • Phone: 801-263-3335
  • Fax: 801-263-2845
Mailing address:
  • Phone: 801-263-3335
  • Fax: 801-263-2845

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1097692501
License Number StateUT

VIII. Authorized Official

Name: DR. MONICA D CHRISTY
Title or Position: DIRECTOR PRESIDENT OF PROFESSIONAL
Credential: PHD
Phone: 801-263-3335