Healthcare Provider Details

I. General information

NPI: 1083273817
Provider Name (Legal Business Name): TAYLER M WAYMENT PSYD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2019
Last Update Date: 06/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3903 HARRISON BLVD STE 300
OGDEN UT
84403-2362
US

IV. Provider business mailing address

3903 HARRISON BLVD STE 300
OGDEN UT
84403-2362
US

V. Phone/Fax

Practice location:
  • Phone: 801-387-5600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number11299830-2501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: