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General NPI Number Information
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NPI Number | 1124234349
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Entity Type | Individual
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Provider Name | PAUL SCOTT FLACK DMFT, LMFT
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Gender | Male
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 06/12/2025
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Provider Practice Location Address
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Address Line | 512 W 750 S STE A
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City | WOODS CROSS
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State | UT
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Zip | 84010-7221
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Country | US
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Telephone | 801-935-8449
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Fax |
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Provider Business Mailing Address
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Address Line | 512 W 750 S STE A
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City | WOODS CROSS
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State | UT
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Zip | 84010-7221
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Country | US
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Telephone | 801-486-4877
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Fax | 801-214-7685
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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 | 5276452-3902
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License Number State | UT
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