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1225197759
RUSSELL CLIFFORD GAEDE
PROVO, UT
NPI
1225197759
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
(Licence: UT 268792-6004)
Enumeration Date
2006-12-08
Last Update Date
2007-07-08
Business Address
Dr. RUSSELL CLIFFORD GAEDE Psy.D., LPC
1835 N 1120 W
PROVO, UT 84604-1180
Phone number: 801-623-4770
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Mailing Address
Dr. RUSSELL CLIFFORD GAEDE Psy.D., LPC
PO BOX 1001
SPANISH FORK, UT 84660-7001
Phone number: 801-623-4770
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