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General NPI Number Information
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NPI Number | 1043017007
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Entity Type | Individual
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Provider Name | CHRISTOPHER CLARK COMBS
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Gender | Male
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Dates
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Enumeration Date | 02/27/2025
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 2940 W MAPLE LOOP DR STE L05
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City | LEHI
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State | UT
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Zip | 84043-6096
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Country | US
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Telephone | 435-610-6212
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Fax |
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Provider Business Mailing Address
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Address Line | 1042 E FORT UNION BLVD # 336
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City | MIDVALE
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State | UT
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Zip | 84047-1800
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Country | US
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Telephone | 385-715-4747
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 484407-3902
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License Number State | UT
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