Individual
DR. ANGELEA PANOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
11820 S MAPLE RIDGE CIR, SANDY, UT 84094-7332
(801) 671-5226
Mailing address
11820 S MAPLE RIDGE CIR, SANDY, UT 84094-7332
(801) 671-5226
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
116245-2501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
116245-2501
STATE OF UTAH: PSYCHOLOGY LICENSE
UT
Enumeration date
03/29/2021
Last updated
03/29/2021
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