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Thomas Evan Mullaly, PSS
Peer Specialist in Salt Lake City, Utah
NPI 1669983417

Thomas Evan Mullaly is a Peer Specialist based in Salt Lake City, UT. Thomas Evan Mullaly practices in Salt Lake City, UT and has the professional credentials of PSS. The NPI Number for Thomas Evan Mullaly is 1669983417 and holds a License No. 796 (Utah).

The current practice location address for Thomas Evan Mullaly is 411 N Grant St, Salt Lake City, UT and can be reached out via phone at 801-359-8862.

Location: 411 N Grant St, Salt Lake City, UT, 84102-3539
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1669983417
Provider Name
Thomas Evan Mullaly
Credential
PSS
Provider Entity Type
Individual
Gender
Male
Address
411 N Grant St, Salt Lake City, UT, 84102-3539
Phone Number
801-359-8862
Fax Number
Provider Enumeration Date
10/19/2017
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
411 N Grant St
City
Salt Lake City
State
Utah
Zip
84116-2725
Phone Number
801-359-8862
Fax Number
person
Provider Business Mailing Address Details
Address
411 N Grant St
City
Salt Lake City
State
Utah
Zip
84116-2725
Phone Number
801-359-8862
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
796 (Utah)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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