Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 4911648-2501 | UT |
Y | 103TC0700X | Clinical Psychologist | 4911648-2501 | UT |
NPI | 1013111996 |
---|---|
Provider Name | Dr. Charlotte J Ferrin |
First Address | Salt Lake City, UT 84108-2019 |
Second Address | Salt Lake City, UT 84105-2149 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2007 |
Last Update Date | 27/01/2014 |