Provider Demographics
NPI:1942422001
Name:DIAGNOSTIC SPECIALISTS INC
Entity type:Organization
Organization Name:DIAGNOSTIC SPECIALISTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT - OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLAM
Authorized Official - Middle Name:VARLEY
Authorized Official - Last Name:ROE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:801-229-1999
Mailing Address - Street 1:1170 N 660 W
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-3020
Mailing Address - Country:US
Mailing Address - Phone:801-229-1999
Mailing Address - Fax:
Practice Address - Street 1:1170 N 660 W
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-3020
Practice Address - Country:US
Practice Address - Phone:801-229-1999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT751076212501103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty