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General NPI Number Information
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NPI Number | 1619258795
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Entity Type | Individual
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Provider Name | STEVEN J. PHELPS
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Gender | Male
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Dates
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Enumeration Date | 09/02/2011
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Last Update Date | 02/16/2016
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Provider Practice Location Address
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Address Line | 750 N 200 W STE 300
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City | PROVO
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State | UT
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Zip | 84601-1690
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Country | US
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Telephone | 801-373-4760
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Fax |
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Provider Business Mailing Address
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Address Line | 3520 N UNIVERSITY AVE STE 225
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City | PROVO
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State | UT
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Zip | 84604-6672
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Country | US
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Telephone | 801-367-7505
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 9210309-3502
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License Number State | UT
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