Individual
DR. SAMUEL ROBERT STORK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D
Contact information
Practice address
500 FOOTHILL DR, SALT LAKE CITY, UT 84148-0001
(801) 582-1565
Mailing address
7198 S NUTREE DR, COTTONWOOD HEIGHTS, UT 84121-4427
(614) 634-6603
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
12453627-2501
UT
Other
Enumeration date
09/30/2022
Last updated
09/30/2022
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