Healthcare Provider Details

I. General information

NPI: 1053409342
Provider Name (Legal Business Name): MATTHEW V. DAVIES PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5353 S 960 E SUITE 230
MURRAY UT
84117-3569
US

IV. Provider business mailing address

5353 S 960 E SUITE 230
MURRAY UT
84117-3569
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 TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number113863-2501
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number113863-2501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: