Robert Bagley, PH.D.

Individual provider Active NPI Marriage & Family Therapist · Salt Lake City, UT

NPI 1083720601 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1083720601
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
6119664-3904 (UT)
Practice address
32 W Winchester St
Suite 101
Salt Lake City, UT 84107-5607
Phone
(801) 263-6367
Fax
(801) 263-6370
NPI assigned
Aug 23, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6119664-3904UTMDMarriage & Family Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 6119664-3904 UT Yes

Addresses

Primary practice location

32 W Winchester St
Suite 101
Salt Lake City, UT 84107-5607

Mailing address

5662 Shady Farm LN
Murray, UT 84107-6714

Other names

  • Rob Bagley Other name

Other providers in Salt Lake City, UT

All providers in Salt Lake City, UT · Marriage & Family Therapist in Utah

Sources for this page

Verify at the official NPI Registry.