Organization Name: | GARY P SAZAMA PHD APC |
NPI Number: | 1003014143 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | NICHOLE ANDERSON (OFFICE MANAGER) |
Mailing Address: | 150 E 200 N Suite O Logan |
State: | UT US |
Postal Code: | 843216602 |
Phone Number: | 4357528010 |
Fax Number: | |
NPI Enumeration Date: | 07/10/2007 |
NPI Last Update Date: | 02/27/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 112064-2504 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |