Healthcare Provider Details

I. General information

NPI: 1780043604
Provider Name (Legal Business Name): BRIGG NOYES, PHD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2016
Last Update Date: 02/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 S 1000 E STE 310 SUITE 310
SALT LAKE CITY UT
84102-1474
US

IV. Provider business mailing address

160 S 1000 E STE 310 SUITE 310
SALT LAKE CITY UT
84102-1474
US

V. Phone/Fax

Practice location:
  • Phone: 801-716-7003
  • Fax:
Mailing address:
  • Phone: 801-716-7003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number5334408-2501
License Number StateUT

VIII. Authorized Official

Name: DR. BRIGG B NOYES
Title or Position: PRESIDENT
Credential: PH.D.
Phone: 801-716-7003