is a Clinical in Provo, Utah. practices all healthcare services and medical treatments related to Clinical. The NPI Number for is 1154432060. The last update date is .
's current location address is 750 North 200 West, Provo, Utah. You can contact this provider via phone number 8013734760 and fax number 8013730639. The mailing address for is 750 North 200 West, Provo, Utah. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 750 North 200 West, Provo, Utah |
| Phone Number | 8013734760 |
| Fax Number | 8013730639 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1154432060 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 750 North 200 West |
|---|---|
| City | Provo |
| State | Utah (UT) |
| Post Code | 84601 |
| Phone Number | 8013734760 |
| Fax Number | 8013730639 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | 1175902501 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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