Individual
JOHN DAVIS VANDERVEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
615 S ARAPEEN DR STE 100, SALT LAKE CITY, UT 84108-1239
(581) 801-7246
Mailing address
1155 E 2100 S APT 6312, SALT LAKE CITY, UT 84106-6809
(248) 736-1422
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
11176091-2501
UT
Other
Enumeration date
09/10/2019
Last updated
12/20/2021
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