| Mark D. Corgiat, Ph.d. | |
|
3903 Harrison Blvd Suite 305 Ogden UT 84403-2314 | |
| (801) 387-3807 | |
| (801) 387-3810 |
| Full Name | Mark D. Corgiat, Ph.d. |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 3903 Harrison Blvd, Ogden, Utah |
| Authorized Official Name and Position | Mark David Corgiat (OWNER,DIRECTOR) |
| Authorized Official Contact | 8016216100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark D. Corgiat, Ph.d. 3903 Harrison Blvd Suite 305 Ogden UT 84403-2314 Ph: (801) 387-3807 | Mark D. Corgiat, Ph.d. 3903 Harrison Blvd Suite 305 Ogden UT 84403-2314 Ph: (801) 387-3807 |
| NPI Number | 1750550075 |
|---|---|
| Provider Enumeration Date | 02/21/2008 |
| Last Update Date | 09/03/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750550075 | NPI | - | NPPES |
| 1336296003 | Other | UT | PERSONAL NPI |
| 1336296003 | Medicaid | UT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 6344743-2501 (Utah) | Primary |
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