Individual
RANDAL S PENNINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
750 NORTH 200 WEST, PROVO, UT 84601
(801) 373-4760
(801) 373-0639
Mailing address
750 NORTH 200 WEST, PROVO, UT 84601
(801) 373-4760
(801) 373-0639
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
49478942501
UT
Other
Enumeration date
08/24/2006
Last updated
07/08/2007
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