Individual
BEVERLY GARDNER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1545 E 3300 S, SALT LAKE CITY, UT 84106-3370
(801) 478-2780
Mailing address
1545 E 3300 S, SALT LAKE CITY, UT 84106-3370
(801) 478-2780
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
S88033
STERLING
UT
Enumeration date
01/18/2006
Last updated
07/08/2007
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