Provider Demographics
NPI:1255119350
Name:PROVO PSYCHOLOGICAL SOLUTIONS
Entity type:Organization
Organization Name:PROVO PSYCHOLOGICAL SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:WALTER
Authorized Official - Last Name:ARNETT
Authorized Official - Suffix:JR
Authorized Official - Credentials:PSYD
Authorized Official - Phone:801-634-3500
Mailing Address - Street 1:365 W 400 S
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84601-4346
Mailing Address - Country:US
Mailing Address - Phone:801-634-3500
Mailing Address - Fax:
Practice Address - Street 1:365 W 400 S
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84601-4346
Practice Address - Country:US
Practice Address - Phone:801-634-3500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-19
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)