Individual
LAURA ANN BLEISTEIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
1300 E CENTER ST, PROVO, UT 84606-3554
(801) 344-4400
Mailing address
1300 E CENTER ST, PROVO, UT 84606-3554
(801) 344-4400
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY28404
CA
Other
Enumeration date
06/10/2008
Last updated
03/22/2023
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