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General NPI Number Information
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NPI Number | 1043803687
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Entity Type | Individual
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Provider Name | GARRETT POLLERT PH.D.
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Gender | Male
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Dates
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Enumeration Date | 02/15/2021
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Last Update Date | 10/29/2025
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Provider Practice Location Address
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Address Line | 32 W 200 S # 213
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City | SALT LAKE CITY
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State | UT
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Zip | 84101-1603
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Country | US
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Telephone | 701-307-0187
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Fax |
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Provider Business Mailing Address
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Address Line | 32 W 200 S # 213
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City | SALT LAKE CITY
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State | UT
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Zip | 84101-1603
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Country | US
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Telephone | 701-307-0187
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1376
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 660
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License Number State | ND
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 13436105-2501
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License Number State | UT
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