Individual
CANDICE WALTRIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
721 N 530 E, OREM, UT 84097-4105
(801) 613-1048
Mailing address
191 E FLOWERFIELD DR, DRAPER, UT 84020-8148
(801) 613-1048
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
9159603-2501
UT
103TC0700X
Clinical Psychologist
9159603-2501
UT
103TC1900X
Counseling Psychologist
9159603-2501
UT
103TF0200X
Forensic Psychologist
9159603-2501
UT
103TP2701X
Group Psychotherapy Psychologist
9159603-2501
UT
Other
Enumeration date
08/09/2012
Last updated
02/13/2017
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