Healthcare Provider Details

I. General information

NPI: 1861837494
Provider Name (Legal Business Name): STEPHANIE VOIGT YABKO PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: STEPHANIE VOIGT PSYD

II. Dates (important events)

Enumeration Date: 05/09/2013
Last Update Date: 12/20/2021
Certification Date: 12/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

265 E 100 S STE 250
SALT LAKE CITY UT
84111-1643
US

IV. Provider business mailing address

265 E 100 S STE 250
SALT LAKE CITY UT
84111-1643
US

V. Phone/Fax

Practice location:
  • Phone: 801-483-2447
  • Fax: 801-486-8705
Mailing address:
  • Phone: 801-483-2447
  • Fax: 801-486-8705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number8819354-2501
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: