Individual
TANYA COLLEDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
1392 W STATE RD, PLEASANT GROVE, UT 84062-5020
(801) 318-8157
Mailing address
PO BOX 454, AMERICAN FORK, UT 84003-0454
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
5533547-2501
UT
Other
Enumeration date
06/07/2008
Last updated
06/07/2008
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