Organization
POLIZZI FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LIZ KOCIOLEK (EXECUTIVE DIRECTOR)
(801) 590-9557
Entity
Organization
Contact information
Practice address
515 E 4500 S, SUITE G220, SALT LAKE CITY, UT 84107-4500
(801) 590-9557
(801) 590-9957
Mailing address
515 E 4500 S, SUITE G220, SALT LAKE CITY, UT 84107-4500
(801) 590-9557
(801) 590-5997
Taxonomy
Speciality
Code
Description
License number
State
103TP0016X
Prescribing (Medical) Psychologist
Primary
178852-1205
UT
Other
Enumeration date
12/12/2016
Last updated
12/12/2016
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