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1275916223
AMY BONIFAY RUSSELL
SALT LAKE CITY, UT
NPI
1275916223
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: UT 4802206-2501)
Enumeration Date
2015-07-08
Last Update Date
2015-07-08
Business Address
Dr. AMY BONIFAY RUSSELL Psy. D.
2469 E FORT UNION BLVD STE 206
SALT LAKE CITY, UT 84121-3417
Phone number: 801-300-6223
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Mailing Address
Dr. AMY BONIFAY RUSSELL Psy. D.
2469 EAST FORT UNION BLVD #206
SLC, UT 84121
Phone number: 801-300-6223
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