Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DERRA GULLICKSON, MA, PSYD
ActiveDERRA GULLICKSON, MA, PSYD is a Clinical Psychologist healthcare provider located in PROVO, Utah. NPI 1255851333 is currently active in the NPPES registry. Verify at CMS.
Clinical Psychologist · PROVO, UT
Registration Details
- NPI Number
- 1255851333
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jun 21, 2017 (9.1927503701918 yrs)
- Last Updated
- Oct 31, 2019
- License
-
10979353-2501 (UT)
Practice Information
- Address
-
750 N FREEDOM BLVDPROVO, UT, 846011677Browse UT providers · Browse ZIP 84601
- Phone
- 8013734760
- Fax
- 8013730639
- Primary Specialty
-
Clinical Psychologist
103TC0700X
Other Clinical Psychologist Providers in PROVO, UT
| Name | Credential | NPI |
|---|---|---|
| DR. ALLAN ROE | PH.D. | 1992703615 |
| MR. JUERGEN ERICH KORBANKA | PHD | 1386600450 |
| THEODORE TERRY | PHD | 1790892685 |
| RANDAL S PENNINGTON | PSYD | 1801903786 |
| LAWRENCE PAUL DUNNING | PH D | 1154432060 |
| RICHARD ALLEN MOODY | PSY.D. | 1922101849 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.