Individual
DR. JUSTIN JAMES MACKENZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
UNIVERSITY OF UTAH, 30 NORTH 1900 EAST, 1B620 SOM, SALT LAKE CITY, UT 84132-0001
(801) 581-6228
Mailing address
UNIVERSITY OF UTAH, 30 NORTH 1900 EAST, 1B620 SOM, SALT LAKE CITY, UT 84132-0001
(801) 581-6228
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
8366220-2501
UT
Other
Enumeration date
12/18/2012
Last updated
12/18/2012
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