Individual
ALEXANDRA M. VILLAGRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
650 S KOMAS DR STE 208, SALT LAKE CITY, UT 84108-1241
(801) 585-5184
Mailing address
650 S KOMAS DR STE 208, SALT LAKE CITY, UT 84108-1241
(801) 585-5184
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
12985121-1205
UT
2084P0800X
Psychiatry Physician
Primary
12985121-1205
UT
2084P0804X
Child & Adolescent Psychiatry Physician
12985121-1205
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/29/2021
Last updated
08/16/2022
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