Most Relevant Information
Provider Data
| NPI Number: | 1003197658 |
| Provider Name: | ELIZA RACHELLE GEDGE PH.D., LP |
| Entity Type: | Individual |
| Taxonomy Code: | 103TC1900X |
| Specialty: | Psychologist |
| License Number: | 6301014858 |
Most Important Dates
| Enumeration Date: | 09/08/2011 |
| Last Updated: | 04/02/2024 |
Provider Practice Location
750 N FREEDOM BLVD
PROVO
UT
846011677
Practice Location Phone/Fax
| Phone: | 8013730639 |
| Fax: | 8013730639 |
Provider Mailing Location
750 N FREEDOM BLVD
PROVO
UT
846011677
Provider Mailing Phone/Fax
| Phone: | 8013730639 |
| Fax: | 8013730639 |