Healthcare Provider Details

I. General information

NPI: 1467788810
Provider Name (Legal Business Name): KLINTON EDWARD HOBBS PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2009
Last Update Date: 04/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 N MAIN ST
SPRINGVILLE UT
84663-1350
US

IV. Provider business mailing address

1491 E 980 N
SPANISH FORK UT
84660-1330
US

V. Phone/Fax

Practice location:
  • Phone: 806-317-6147
  • Fax:
Mailing address:
  • Phone: 806-317-6147
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number10392545-2501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: