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1811527468
RYAN J LACKNER
SALT LAKE CITY, UT
NPI
1811527468
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: UT 11448769-2501)
Enumeration Date
2020-01-23
Last Update Date
2020-01-23
Business Address
Dr. RYAN J LACKNER PhD
500 FOOTHILL DR
SALT LAKE CITY, UT 84148-0001
Phone number: 801-582-1565
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Mailing Address
Dr. RYAN J LACKNER PhD
975 E GARFIELD AVE APT 2
SALT LAKE CITY, UT 84105-3377
Phone number: 574-360-6884
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