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Individual

DR. GAIL JOANNE LIESE

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
7309 S 180 W, MIDVALE, UT 84047-1020
(801) 565-6800
(801) 569-9718
Mailing address
462 S 1100 E, SALT LAKE CITY, UT 84102-3116
(801) 355-7265

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2708742501
UT

Other

Enumeration date
01/27/2006
Last updated
07/08/2007
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