Doctor Name: | DR. KATY L O'BANION |
NPI Number: | 1437149838 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | 1090532501 |
Business Practice Address: | 2290 E 4500 S Suite 100 Holladay, UT - 841174492 |
Business Phone Number: | 8012720390 |
Business Fax Number: | 8012720118 |
Mailing Address: | 2290 E 4500 S, Suite 100 HOLLADAY |
State: | UT |
Postal Code: | 841174492 |
Phone Number: | 8012720390 |
Fax Number: | 8012720118 |
NPI Enumeration Date: | 10/26/2005 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 1090532501 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |