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General NPI Number Information
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NPI Number | 1568825941
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Entity Type | Individual
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Provider Name | KELSEY CLEWS FRYER M.A., PSY.D
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Gender | Female
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Dates
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Enumeration Date | 04/01/2016
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 856 S MAIN ST STE E
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City | PLEASANT GROVE
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State | UT
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Zip | 84062-3528
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Country | US
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Telephone | 904-501-9588
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Fax |
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Provider Business Mailing Address
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Address Line | 2702 N 900 W
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City | PLEASANT GROVE
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State | UT
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Zip | 84062-9030
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Country | US
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Telephone | 904-501-9588
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 9529289-2501
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 95292892501
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License Number State | UT
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