Organization
KENT W ANDERSON PHD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENT W ANDERSON PHD (PRESIDENT/OWNER)
(435) 752-7627
Entity
Organization
Contact information
Practice address
545 W 465 N, SUITE 130, PROVIDENCE, UT 84332-8003
(435) 752-7627
(435) 752-7802
Mailing address
545 W 465 N, SUITE 130, PROVIDENCE, UT 84332-8003
(435) 752-7627
(435) 752-7802
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
324469-2501
UT
Other
Enumeration date
01/27/2010
Last updated
01/27/2010
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