Professional Clinical Management

NPI #1023263191 in Provo, Utah

Provider Information

NPI Number: 1023263191
Entity Type: Organization
Organization Name: Professional Clinical Management
Primary Specialty: Psychologist
Enumeration Date: Nov 17, 2008
Last Updated: Nov 17, 2008

Practice Location

Address: 1355 N UNIVERSITY AVE STE 200
City: Provo
State: Utah
ZIP Code: 84604-2721
Phone: (801) 221-0223

Authorized Official

Name: MR. RANDALL F HYDE, PH.D.
Title: CLINICAL DIRECTOR
Phone: (801) 221-0223

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist	103T00000X	Primary

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