Individual
OLIVIA CARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
1165 E 300 N, PROVO, UT 84606-3539
(801) 377-1213
Mailing address
750 N 200 W STE 300, PROVO, UT 84601-1690
(801) 373-4760
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
7417679-2504
UT
Other
Enumeration date
06/01/2007
Last updated
02/22/2011
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