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General NPI Number Information
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NPI Number | 1487622908
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Entity Type | Individual
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Provider Name | ROBERT FREDERICK PRAMANN JR.
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Gender | Male
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Dates
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Enumeration Date | 03/10/2006
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Last Update Date | 10/31/2024
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Provider Practice Location Address
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Address Line | 404 E 4500 S STE B22
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City | MURRAY
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State | UT
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Zip | 84107-2776
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Country | US
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Telephone | 801-268-1564
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Fax | 801-268-1565
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Provider Business Mailing Address
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Address Line | 404 E 4500 S STE B22
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City | MURRAY
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State | UT
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Zip | 84107-2776
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Country | US
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Telephone | 801-268-1564
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Fax | 801-268-1565
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 114495-2501
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License Number State | UT
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