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General NPI Number Information
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NPI Number | 1063652899
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Entity Type | Individual
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Provider Name | PAUL ANTHONY SMYTH PH.D
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Gender | Male
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Dates
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Enumeration Date | 03/06/2009
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Last Update Date | 03/06/2009
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Provider Practice Location Address
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Address Line | 418 CLIFFVIEW DR.
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City | CASTLE VALLEY
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State | UT
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Zip | 84532-9611
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Country | US
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Telephone | 435-259-9484
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 1901 418 CLIFFVIEW DR
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City | CASTLE VALLEY
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State | UT
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Zip | 84532-9611
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Country | US
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Telephone | 435-259-9484
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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 | 333582-3902
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License Number State | UT
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