MEDICARE: DR. CHRIS K WEHL PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	115392 - 2501	UT

General Provider Information

NPI Number	:	1184619561
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRIS K WEHL PH.D.

Provider Business Mailing Address
First Line	:	864 WINDSOR LN
Second Line	:
City	:	BOUNTIFUL
State	:	UT
Zip	:	84010-4400
Country	:	US
Telephone Number	:	801-864-1950
Fax Number	:

Provider Business Practice Location Address
First Line	:	1263 E SOUTH TEMPLE APT 9
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84102-1721
Country	:	US
Telephone Number	:	801-350-0115
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2005
Last Update Date	:	11/30/2022

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