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General NPI Number Information
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NPI Number | 1346857026
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Entity Type | Individual
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Provider Name | ADAM HANLEY
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Gender | Male
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Dates
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Enumeration Date | 09/28/2020
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Last Update Date | 09/28/2020
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Provider Practice Location Address
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Address Line | 395 S 1500 E
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City | SALT LAKE CITY
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State | UT
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Zip | 84112-8909
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Country | US
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Telephone | 801-213-4191
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Fax |
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Provider Business Mailing Address
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Address Line | 474 E HARVARD AVE
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City | SALT LAKE CITY
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State | UT
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Zip | 84111-4736
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Country | US
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Telephone |
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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