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General NPI Number Information
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NPI Number | 1235531344
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Entity Type | Organization
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Legal Business Name | JAMES S KAHN PHD LLC
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Dates
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Enumeration Date | 09/19/2014
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Last Update Date | 09/19/2014
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Provider Practice Location Address
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Address Line | 675 E 2100 S SUITE 250
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City | SALT LAKE CITY
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State | UT
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Zip | 84106-1887
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Country | US
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Telephone | 801-641-8203
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Fax | 801-484-3862
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Provider Business Mailing Address
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Address Line | 675 E 2100 S SUITE 250
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City | SALT LAKE CITY
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State | UT
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Zip | 84106-1887
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Country | US
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Telephone | 801-641-8203
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Fax | 801-484-3862
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | CARI DENE PETERSON
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Credential |
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Telephone | 801-466-9233
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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 | 115695 2501
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License Number State | UT
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