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General NPI Number Information
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NPI Number | 1710844162
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Entity Type | Organization
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Legal Business Name | SPECTROPOLIS SLC
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Dates
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Enumeration Date | 01/07/2026
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 1537 S MAIN ST
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City | SALT LAKE CITY
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State | UT
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Zip | 84115-5315
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Country | US
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Telephone | 385-777-9444
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Fax |
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Provider Business Mailing Address
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Address Line | 1537 S MAIN ST
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City | SALT LAKE CITY
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State | UT
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Zip | 84115-5315
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Country | US
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Telephone | 385-777-9444
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JULIA CONNELLY
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Credential | PH.D.
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Telephone | 801-792-9922
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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