MEDICARE: HANNAH MUETZELFELD PHD

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	103T00000X	Psychologist	11900527-2501	UT

General Provider Information

NPI Number	:	1609609445
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANNAH MUETZELFELD PHD

Provider Business Mailing Address
First Line	:	987 CHATHAM DR
Second Line	:
City	:	NORTH SALT LAKE
State	:	UT
Zip	:	84054-6121
Country	:	US
Telephone Number	:	404-247-7558
Fax Number	:

Provider Business Practice Location Address
First Line	:	987 CHATHAM DR
Second Line	:
City	:	NORTH SALT LAKE
State	:	UT
Zip	:	84054-6121
Country	:	US
Telephone Number	:	404-247-7558
Fax Number	:

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

Provider Enumeration Date	:	08/26/2024
Last Update Date	:	08/26/2024

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