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Organization
UNIVERSITY OF UTAH
Active
Organization
UNIVERSITY OF UTAH
Active
Other names
assessment & referral services
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY LUNDBERG PD.D (ASSOCIATE PROFESSOR OF PSYCHIATRY)
(801) 532-1850
Entity
Organization
Contact information
Practice address
450 S 900 E STE 300, SALT LAKE CITY, UT 84102-3064
(801) 534-7921
Mailing address
450 S 900 E STE 300, SALT LAKE CITY, UT 84102-3064
(801) 534-7921
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6262094-3501
UT
Other
Enumeration date
11/04/2010
Last updated
11/04/2010
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