Individual
RYAN WOODROW WILKES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
1060 E 100 S, SUITE 100, SALT LAKE CITY, UT 84102-1501
(801) 590-0525
Mailing address
1443 E LAIRD AVE, SALT LAKE CITY, UT 84105-1938
(540) 421-6660
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
10086571-2501
UT
103TC0700X
Clinical Psychologist
PY9246
FL
Other
Enumeration date
01/31/2012
Last updated
01/09/2017
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