Provider Demographics
NPI:1861402026
Name:SOUTOR FARHART, SARI ANN (PHD)
Entity type:Individual
Prefix:
First Name:SARI
Middle Name:ANN
Last Name:SOUTOR FARHART
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:SARI
Other - Middle Name:ANN
Other - Last Name:SOUTOR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:4335 S 2700 E
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84124-3720
Mailing Address - Country:US
Mailing Address - Phone:801-910-6191
Mailing Address - Fax:435-487-9107
Practice Address - Street 1:2760 RASMUSSEN RD
Practice Address - Street 2:STE 205
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84098-5684
Practice Address - Country:US
Practice Address - Phone:435-645-9240
Practice Address - Fax:435-487-9687
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT60525992501103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent