Individual
DR. TYLER R. PEDERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1500 WSC, PROVO, UT 84602
(801) 830-9155
Mailing address
1500 WSC, PROVO, UT 84602
(801) 422-3035
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
4911738-2501
UT
Other
Enumeration date
12/17/2010
Last updated
12/17/2010
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