BRUCE K JACOBSON PH D P C NPI 1417913575

NPI Information

BRUCE K JACOBSON PH D P C is an adult mental health clinic center in Salt Lake City, UT. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. BRUCE K JACOBSON PH D P C NPI is 1417913575. The provider is registered as an organization entity type.

The provider's business location address is:

4190 HIGHLAND DR
SUITE 211
SALT LAKE CITY, UT
ZIP 84124-600
Phone: (801) 272-0614
Fax: (801) 272-0678

The provider's authorized official is Bruce K Jacobson .
The authorized official title is President And Psychologist and has the following contact phone number (801) 272-0614.

The enumeration date for this NPI number is 4/26/2006 and was last updated on 3/16/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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