Individual
DR. RANDY GILLILAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
395 W COUGAR BLVD STE 803, PROVO, UT 84604-3311
(801) 235-7246
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
9655966-2501
UT
Other
Enumeration date
04/05/2016
Last updated
10/25/2024
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