Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 113863-2501 | UT |
N | 103TF0200X | Forensic Psychologist | 113863-2501 | UT |
NPI | 1053409342 |
---|---|
Provider Name | Dr. Matthew V. Davies |
First Address | Murray, UT 84117-3569 |
Second Address | Murray, UT 84117-3569 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 08/07/2007 |