Individual
JONATHAN CODELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
4 QUIETWOOD LN, SANDY, UT 84092-4845
(801) 828-5271
Mailing address
4 QUIETWOOD LN, SANDY, UT 84092-4845
(801) 828-5271
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1375
NM
Other
Enumeration date
09/10/2015
Last updated
09/10/2015
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