| Ebtsl Psychiatry, Pllc | |
|
2225 E Murray Holladay Rd Ste 116 Holladay UT 84117-5382 | |
| (877) 919-4521 | |
| Not Available |
| Full Name | Ebtsl Psychiatry, Pllc |
|---|---|
| Speciality | Psychiatry & Neurology - Child & Adolescent Psychiatry |
| Location | 2225 E Murray Holladay Rd Ste 116, Holladay, Utah |
| Authorized Official Name and Position | Adrienne C Bennett (CLINIC COORDINATOR) |
| Authorized Official Contact | 4253619272 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ebtsl Psychiatry, Pllc 2225 E Murray Holladay Rd Ste 116 Holladay UT 84117-5382 Ph: (877) 919-4521 | Ebtsl Psychiatry, Pllc 2225 E Murray Holladay Rd Ste 116 Holladay UT 84117-5382 Ph: (877) 919-4521 |
| NPI Number | 1275369563 |
|---|---|
| Provider Enumeration Date | 09/12/2024 |
| Last Update Date | 09/12/2024 |
| Certification Date | 09/12/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275369563 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | (* (Not Available)) | Primary |
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