Individual
EMILY YOUNG BULLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
240 N EAST PROMONTORY STE 200, FARMINGTON, UT 84025-2950
(801) 844-1615
(844) 221-4750
Mailing address
240 N EAST PROMONTORY STE 200, FARMINGTON, UT 84025-2950
(801) 844-1615
(844) 221-4750
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7510289-2501
LICENSED PSYCHOLOGIST
UT
Enumeration date
10/12/2007
Last updated
02/21/2018
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