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Individual

DR. JERRY LYNN SANDBERG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
1470 N MAIN ST STE B, BOUNTIFUL, UT 84010-5996
(801) 299-9026
(801) 299-9026
Mailing address
1470 N MAIN ST STE B, BOUNTIFUL, UT 84010-5996
(801) 299-9026
(801) 299-9026

Taxonomy

Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
117488-2501
UT

Other

Enumeration date
11/02/2006
Last updated
06/15/2012
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