Individual
DR. KATHERINE THOMAS FORTENBERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
375 CHIPETA WAY, SUITE A, SALT LAKE CITY, UT 84108-1260
(801) 587-3379
Mailing address
375 CHIPETA WAY, SUITE A, SALT LAKE CITY, UT 84108-1260
(801) 587-3379
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
50871
MS
103TC0700X
Clinical Psychologist
Primary
8106647-2501
UT
103TH0004X
Health Psychologist
50871
MS
103TH0004X
Health Psychologist
8106647-2501
UT
Other
Enumeration date
03/11/2011
Last updated
10/28/2021
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