Individual
DR. STEPHANIE CREEKPAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
5770 S 1500 W, TAYLORSVILLE, UT 84123
(801) 313-7770
Mailing address
5770 S 1500 W, TAYLORSVILLE, UT 84123
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
6301014440
MI
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
8109989-2501
UT
Other
Enumeration date
10/18/2010
Last updated
11/06/2012
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