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General NPI Number Information
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NPI Number | 1952710071
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Entity Type | Organization
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Legal Business Name | THE PEARCE INSTITUTE OF CHILD AND FAMILY PSYCHOLOGY, LLC
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Dates
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Enumeration Date | 08/04/2014
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Last Update Date | 08/04/2014
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Provider Practice Location Address
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Address Line | 231 E 2100 S SUITE 203
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City | SALT LAKE CITY
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State | UT
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Zip | 84115-2187
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Country | US
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Telephone | 801-901-4311
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Fax |
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Provider Business Mailing Address
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Address Line | 231 E 2100 S SUITE 203
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City | SALT LAKE CITY
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State | UT
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Zip | 84115-2187
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Country | US
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Telephone | 801-901-4311
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | DR. BRETT D. PEARCE
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Credential | PSYD
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Telephone | 801-901-4311
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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 | 8546756-2501
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License Number State | UT
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