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1780720888
LAURA LYN BROCKBANK
SALT LAKE CITY, UT
NPI
1780720888
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
103TC2200X Psychologist, Clinical Child & Adolescent
(Licence: UT 363425-2501)
Enumeration Date
2007-01-29
Last Update Date
2007-07-08
Business Address
Dr. LAURA LYN BROCKBANK Ph.D.
1399 S 700 E SUITE 7
SALT LAKE CITY, UT 84105-2149
Phone number: 801-483-3068
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Mailing Address
Dr. LAURA LYN BROCKBANK Ph.D.
1966 LINCOLN LN
SALT LAKE CITY, UT 84124-2745
Phone number: 801-278-1139
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