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Clinical Neuropsychologist

Slc, Utah

Provider NPI: 1790745248

Provider Information:
Gender: M
Sole Proprietor

Practice Location:
230 S 500 E SUITE 100 SLC, UT 84102 US
Tel: 801-532-1484  Fax: 801-532-1486

Business Mailing Address:
230 S 500 E SUITE 100 SLC, UT 84102 US
Tel: 801-532-1484  Fax: 801-532-1486

Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
X103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
X103TC0700XBehavioral Health & Social Service Providers


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