Individual
DR. STEVAN LARS NIELSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1526 WSC, BYU, PROVO, UT 84602
(801) 422-3035
(801) 422-0175
Mailing address
1526 WSC, BYU, PROVO, UT 84602
(801) 422-3035
(801) 422-0175
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
115238-2501
UT
Other
Enumeration date
03/14/2007
Last updated
12/03/2010
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