Basic Information
| Provider Information | |||||||||
| NPI: | 1942224829 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SZYKULA | ||||||||
| FirstName: | STEVEN | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1208 E 3300 S | ||||||||
| Address2: | |||||||||
| City: | SALT LAKE CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841062522 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8014831600 | ||||||||
| FaxNumber: | 8014831610 | ||||||||
| Practice Location | |||||||||
| Address1: | 1208 E 3300 S | ||||||||
| Address2: | |||||||||
| City: | SALT LAKE CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841062522 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8014831600 | ||||||||
| FaxNumber: | 8014831610 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/26/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | 110839-2501 | UT | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.