Provider Demographics
NPI:1699323550
Name:EYRE, SCOTT
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:EYRE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:927 S 890 W
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84601-4563
Mailing Address - Country:US
Mailing Address - Phone:801-669-4969
Mailing Address - Fax:
Practice Address - Street 1:879 S OREM BLVD STE 1
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84058-5030
Practice Address - Country:US
Practice Address - Phone:801-802-8608
Practice Address - Fax:801-221-1042
Is Sole Proprietor?:No
Enumeration Date:2019-09-03
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool