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General NPI Number Information
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NPI Number | 1851233282
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Entity Type | Organization
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Legal Business Name | A CHILD'S PLACE, LLC
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Dates
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Enumeration Date | 04/06/2026
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Last Update Date | 04/06/2026
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Provider Practice Location Address
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Address Line | 4568 S HIGHLAND DR STE 100
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City | SALT LAKE CITY
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State | UT
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Zip | 84117-4234
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Country | US
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Telephone | 801-232-5363
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Fax |
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Provider Business Mailing Address
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Address Line | 4568 S HIGHLAND DR STE 100
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City | SALT LAKE CITY
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State | UT
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Zip | 84117-4234
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Country | US
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Telephone | 801-232-5363
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Fax |
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Authorized Official
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Title or Position | OWNER/PSYCHOLOIGST
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Name | CARLA JEAN REYES
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Credential | PH.D.
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Telephone | 801-232-5363
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number |
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License Number State |
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