Provider Demographics
NPI:1316937410
Name:EMPEY, DALLAS (PHD)
Entity type:Individual
Prefix:DR
First Name:DALLAS
Middle Name:
Last Name:EMPEY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:653 N MAIN ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FARMINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84025-3645
Mailing Address - Country:US
Mailing Address - Phone:801-644-9244
Mailing Address - Fax:801-451-9802
Practice Address - Street 1:653 N MAIN ST
Practice Address - Street 2:SUITE 100
Practice Address - City:FARMINGTON
Practice Address - State:UT
Practice Address - Zip Code:84025-3645
Practice Address - Country:US
Practice Address - Phone:801-644-9244
Practice Address - Fax:801-451-9802
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT117714-2501103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTR61046Medicare UPIN