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Individual

LORA ISRAELSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
6405 OLD MAIN HILL, LOGAN, UT 84322-0001
(435) 797-4200
(844) 308-5865
Mailing address
6405 OLD MAIN HILL, LOGAN, UT 84322-6405
(435) 797-0576
(844) 308-5865

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
13456930-2501
UT
103TM1800X
Intellectual & Developmental Disabilities Psychologist
13456930-2501
UT

Other

Enumeration date
08/07/2023
Last updated
08/07/2023
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