Individual
BRUCE CRAIG POULSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
5770 S 1500 W, TAYLORSVILLE, UT 84123-5216
(801) 265-3031
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 442-1400
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
4849539-2501
UT
Other
Enumeration date
03/22/2007
Last updated
07/08/2007
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