Individual
LARENE KIM SMART FRASER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
475 W 260 N, OREM, UT 84057-1970
(801) 221-9930
Mailing address
475 W 260 N, OREM, UT 84057-1970
(801) 221-9930
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
10478217-2501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1396085718
—
UT
Enumeration date
08/12/2013
Last updated
08/04/2025
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