Individual
DR. RISA TAKARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
363 E 1200 S, OREM, UT 84058-6904
(801) 224-2313
Mailing address
363 E 1200 S, OREM, UT 84058-6904
(801) 224-2313
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
8772962-2501
UT
Other
Enumeration date
03/17/2021
Last updated
07/16/2021
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