Doctor Name: | STANLEY CARL SMOOT |
NPI Number: | 1356697908 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PHD |
License Number: | 4913128-2501 |
Business Practice Address: | 1920 E 7160 S Cottonwood Heights, UT - 841213720 |
Business Phone Number: | 8015974615 |
Business Fax Number: | |
Mailing Address: | 1920 E 7160 S, COTTONWOOD HEIGHTS |
State: | UT |
Postal Code: | 841213720 |
Phone Number: | 8015974615 |
Fax Number: | |
NPI Enumeration Date: | 08/01/2012 |
NPI Last Update Date: | 08/01/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 4913128-2501 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |