Evidence Based Treatment Centers of Salt Lake City, Pllc

NPI #1326783689 in Holladay, Utah

Provider Information

NPI Number: 1326783689
Entity Type: Organization
Organization Name: Evidence Based Treatment Centers of Salt Lake City, Pllc
Subpart: Yes (part of a larger organization)
Parent Organization: EVIDENCE BASED TREATMENT CENTERS OF SEATTLE, PLLC
Primary Specialty: Psychologist - Clinical
Enumeration Date: May 2, 2022
Last Updated: Feb 2, 2023

Practice Location

Address: 2225 E MURRAY HOLLADAY RD STE 116
City: Holladay
State: Utah
ZIP Code: 84117-5382
Phone: (206) 374-0109

Authorized Official

Name: ADRIENNE C BENNETT, BS
Title: CLINIC COORDINATOR
Phone: (425) 361-9272

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Clinical Child & Adolescent — Clinical Child & Adolescent	103TC2200X
Psychologist - Clinical — Clinical	103TC0700X	Primary

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