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Individual

MCCALL BOWCUT LYON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
5242 S 4820 W, KEARNS, UT 84118-6422
(801) 966-4251
Mailing address
350 S 400 E, SALT LAKE CITY, UT 84111-2908
(801) 582-5534

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
103TC0700X
Clinical Psychologist
Primary
9533115-2501
UT

Other

Enumeration date
01/07/2013
Last updated
10/13/2016
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