Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 5334408-2501 | UT |
NPI | 1083842488 |
---|---|
Provider Name | Dr. Brigg Bromley Noyes |
First Address | Salt Lake City, UT 84102-1138 |
Second Address | Salt Lake City, UT 84102-1138 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2009 |
Last Update Date | 24/06/2009 |