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General NPI Number Information
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NPI Number | 1962260992
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Entity Type | Individual
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Provider Name | FEEA LEIFKER PHD, MPH
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Gender | Female
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Dates
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Enumeration Date | 03/13/2024
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Last Update Date | 03/13/2024
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Provider Practice Location Address
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Address Line | 260 S CENTRAL CAMPUS DR STE 3525
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City | SALT LAKE CITY
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State | UT
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Zip | 84112-9199
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Country | US
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Telephone | 801-581-4697
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Fax |
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Provider Business Mailing Address
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Address Line | 380 S 1530 E RM 502
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City | SALT LAKE CITY
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State | UT
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Zip | 84112-0251
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Country | US
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Telephone |
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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 | 10221144-2501
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License Number State | UT
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