| Ctr Supports | |
|
10182 S Campden Ct South Jordan UT 84009-7109 | |
| (801) 788-4988 | |
| (801) 206-3588 |
| Full Name | Ctr Supports |
|---|---|
| Speciality | Psychologist - Cognitive & Behavioral |
| Location | 10182 S Campden Ct, South Jordan, Utah |
| Authorized Official Name and Position | Cobilynn R Dickinson (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8014503164 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ctr Supports 10182 S Campden Ct South Jordan UT 84009-7109 Ph: () - | Ctr Supports 10182 S Campden Ct South Jordan UT 84009-7109 Ph: (801) 788-4988 |
| NPI Number | 1497254304 |
|---|---|
| Provider Enumeration Date | 02/06/2018 |
| Last Update Date | 02/06/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497254304 | NPI | - | NPPES |
| 325706-2501 | Other | UT | LICENSE PSYCHOLOGIST |
| 1658550246 | Medicaid | UT | |
| 12195372 | Other | CAQH | |
| 325706-2506 | Other | UT | BEHAVIOR ANALYST |
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