DERRA GULLICKSON, MA, PSYD

Psychologist - Clinical

Active Individual
NPI: 1255851333

Practice Address

750 N FREEDOM BLVD
Provo, UT 84601

Phone: (801) 373-4760

Specialties

Specialty Code Primary License
Psychologist - Clinical 103TC0700X Yes 10979353-2501 (UT)

Frequently Asked Questions

NPI 1255851333 is the National Provider Identifier for DERRA GULLICKSON, MA, PSYD, a Psychologist - Clinical provider located in Provo, UT. This NPI was enumerated on June 21, 2017.
DERRA GULLICKSON, MA, PSYD practices at 750 N FREEDOM BLVD, Provo, UT 84601.

Quick Facts

NPI
1255851333
Type
Individual
Enumerated
Jun 21, 2017
Last Updated
Oct 31, 2019

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