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General NPI Number Information
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NPI Number | 1487841557
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Entity Type | Organization
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Legal Business Name | ASPEN THERAPY INC
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Dates
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Enumeration Date | 10/02/2007
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Last Update Date | 02/05/2008
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Provider Practice Location Address
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Address Line | 3707 N CANYON RD # 2C
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City | PROVO
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State | UT
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Zip | 84604-4596
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Country | US
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Telephone | 801-225-3111
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Fax | 801-225-9809
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Provider Business Mailing Address
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Address Line | 3707 N CANYON RD # 2C
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City | PROVO
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State | UT
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Zip | 84604-4596
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Country | US
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Telephone | 801-225-3111
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Fax | 801-225-9809
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RUTH M KILLPACK
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Credential | PH.D.
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Telephone | 801-225-3111
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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 | 116278-3902
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License Number State | UT
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