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General NPI Number Information
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NPI Number | 1841846151
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Entity Type | Individual
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Provider Name | BRYAN GREGORY MESSINA PHD
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Gender | Male
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Dates
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Enumeration Date | 08/13/2019
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 500 FOOTHILL DR
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City | SALT LAKE CITY
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State | UT
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Zip | 84148-3111
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Country | US
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Telephone | 512-658-6842
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Fax |
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Provider Business Mailing Address
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Address Line | 502 W 7TH ST STE 100
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City | ERIE
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State | PA
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Zip | 16502-1333
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Country | US
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Telephone |
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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 | PS020406
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY30901
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License Number State | CA
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