Healthcare Provider Details

I. General information

NPI: 1124819115
Provider Name (Legal Business Name): CHRISTOPHER JOHN TAPPEL PSYD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2025
Last Update Date: 06/05/2025
Certification Date: 06/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2223 S HIGHLAND DR STE 297
SALT LAKE CITY UT
84106-3672
US

IV. Provider business mailing address

1800 W FOX BAY DR UNIT C103
HEBER CITY UT
84032-4261
US

V. Phone/Fax

Practice location:
  • Phone: 801-738-7616
  • Fax:
Mailing address:
  • Phone: 253-222-5540
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number14222918-2504
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: