Provider Demographics
NPI:1750560991
Name:BRIGGS, DAVID SCOTT (EDS)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:SCOTT
Last Name:BRIGGS
Suffix:
Gender:M
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2194 W AUTUMN DR
Mailing Address - Street 2:
Mailing Address - City:MAPLETON
Mailing Address - State:UT
Mailing Address - Zip Code:84664-5694
Mailing Address - Country:US
Mailing Address - Phone:307-275-0869
Mailing Address - Fax:
Practice Address - Street 1:1508 SPRINGDELL CIRCLE, PROVO CANYON RD, PROVO, UT 8460
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604
Practice Address - Country:US
Practice Address - Phone:410-975-7558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-24
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13425370-6010101YM0800X
WYCSSP07101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT13425370-6010OtherDIVISION OF OCCUPATIONAL AND PROFESSIONAL LICENSING