Individual
MARY MELINDA RUSSELL-STAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
415 MEDICAL DR STE D101, BOUNTIFUL, UT 84010-8905
(801) 574-4405
(801) 295-5537
Mailing address
415 MEDICAL DR STE D101, BOUNTIFUL, UT 84010-8905
(801) 574-4405
(801) 295-5537
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
9153826-2501
UT
Other
Enumeration date
08/11/2017
Last updated
09/12/2025
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