Organization
UNIVERSITY OF UTAH
Active
Parent organization
UNIVERSITY OF UTAH
Other names
Assessment & Referral Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
UNIVERSITY OF UTAH
Authorized official
DR. KELLY LUNDBERG PHD (DIRECTOR)
(801) 534-7905
Entity
Organization
Contact information
Practice address
450 S 900 E, SUITE 300, SALT LAKE CITY, UT 84102-2981
(801) 532-1850
(801) 532-3608
Mailing address
450 S 900 E, SUITE 300, SALT LAKE CITY, UT 84102-3608
(801) 532-1850
(801) 532-3608
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
—
UT
Other
Enumeration date
07/16/2012
Last updated
07/16/2012
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