DERRA GULLICKSON

PROVO, UT
NPI1255851333
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy103TC0700X Psychologist, Clinical
(Licence: UT  10979353-2501)
Enumeration Date2017-06-21
Last Update Date2019-10-31
Business Address
DERRA GULLICKSON MA, PsyD
750 N FREEDOM BLVD
PROVO, UT 84601-1677
Phone number: 801-373-4760
Mailing Address
DERRA GULLICKSON MA, PsyD
750 N FREEDOM BLVD
PROVO, UT 84601-1677
Phone number: 801-373-4760
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