Healthcare Provider Details

I. General information

NPI: 1013975853
Provider Name (Legal Business Name): DENISE D THORNHILL PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DEBORAH DENISE THORNHILL PH.D.

II. Dates (important events)

Enumeration Date: 05/02/2006
Last Update Date: 04/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 E 3900 S SUITE 202
SALT LAKE CITY UT
84107-2182
US

IV. Provider business mailing address

715 E 3900 S SUITE 202
SALT LAKE CITY UT
84107-2182
US

V. Phone/Fax

Practice location:
  • Phone: 801-261-5141
  • Fax: 801-261-5142
Mailing address:
  • Phone: 801-261-5141
  • Fax: 801-261-5142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number332378-2501
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number332378-2501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: