Child & Family Institute, Llc | |
1910 Prospector Ave Suite 201 Park City UT 84060-7211 | |
(435) 645-9240 | |
(435) 645-9237 |
Full Name | Child & Family Institute, Llc |
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Speciality | Clinical Neuropsychologist |
Location | 1910 Prospector Ave, Park City, Utah |
Authorized Official Name and Position | Jennifer Santosusso Gale (OWNER/PEDIATRIC NEUROPSYCHOLOGIST) |
Authorized Official Contact | 4356459240 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Child & Family Institute, Llc 1910 Prospector Ave Suite 201 Park City UT 84060-7211 Ph: (435) 645-9240 | Child & Family Institute, Llc 1910 Prospector Ave Suite 201 Park City UT 84060-7211 Ph: (435) 645-9240 |
NPI Number | 1902865595 |
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Provider Enumeration Date | 03/21/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1902865595 | NPI | - | NPPES |
149727806001 | Medicaid | UT |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103G00000X | Clinical Neuropsychologist | 377761-2501 (Utah) | Primary |
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