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General NPI Number Information
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NPI Number | 1235374984
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Entity Type | Organization
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Legal Business Name | UTAH STATE UNIVERSITY
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Dates
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Enumeration Date | 12/10/2008
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Last Update Date | 08/28/2018
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Provider Practice Location Address
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Address Line | 6410 OLD MAIN HL
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City | LOGAN
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State | UT
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Zip | 84322-6410
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Country | US
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Telephone | 435-797-1346
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Fax | 844-308-5865
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Provider Business Mailing Address
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Address Line | 6410 OLD MAIN HL
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City | LOGAN
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State | UT
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Zip | 84322-6410
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Country | US
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Telephone | 435-797-1346
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Fax | 844-308-5865
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Authorized Official
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Title or Position | FINANCIAL OFFICER
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Name | KATHRYN CLEMENTS
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Credential |
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Telephone | 435-797-5830
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State |
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