Individual
MICHELLE ERTL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
4525 S 2300 E STE 201, HOLLADAY, UT 84117-4639
(801) 896-7624
Mailing address
2636 S IMPERIAL ST, SALT LAKE CITY, UT 84106-3615
(719) 221-9971
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
10244648-2501
UT
Other
Enumeration date
06/18/2017
Last updated
07/12/2023
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