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Organization

UTAH STATE UNIVERSITY

Active
Parent organization
UTAH STATE UNIVERSIRY
Other names
USU Psychology Community Clinic
Organization subpart
Yes

Provider details

NPI number
Legal business name
UTAH STATE UNIVERSIRY
Authorized official
SUE REEDER (BILLING LEAD)
(435) 797-1346
Entity
Organization

Contact information

Practice address
2810 OLD MAIN HL, LOGAN, UT 84322
(435) 797-3401
(435) 797-1448
Mailing address
6405 OLD MAIN HL, LOGAN, UT 84322-6405
(435) 797-1346
(435) 797-1448

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
103TC0700X
Clinical Psychologist
103TC2200X
Clinical Child & Adolescent Psychologist

Other

Enumeration date
03/12/2007
Last updated
06/08/2018
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