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General NPI Number Information
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NPI Number | 1619902079
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Entity Type | Individual
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Provider Name | DAVID GAMBLES PH.D.
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Gender | Male
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1323 W 7900 S SUITE 106
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City | WEST JORDAN
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State | UT
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Zip | 84088-7933
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Country | US
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Telephone | 801-440-5892
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Fax |
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Provider Business Mailing Address
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Address Line | 3516 W 8070 S
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City | WEST JORDAN
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State | UT
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Zip | 84088-4575
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Country | US
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Telephone | 801-265-3053
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 317599-2501
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License Number State | UT
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