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Individual

EMILY RUTH SMITH PUTNAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
668 E 12225 S STE 202, DRAPER, UT 84020-8385
(801) 619-3569
Mailing address
668 E 12225 S STE 202, DRAPER, UT 84020-8385
(801) 619-3569

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
8729485-2504
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1164589669
NPI REGISTRY
UT
Enumeration date
06/09/2014
Last updated
06/09/2014
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