Provider Demographics
NPI:1043927478
Name:O'GRADY, KARI A (PSYCHOLOGIST)
Entity Type:Individual
Prefix:DR
First Name:KARI
Middle Name:A
Last Name:O'GRADY
Suffix:
Gender:F
Credentials:PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1508 SPRINGDELL CIR
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-9632
Mailing Address - Country:US
Mailing Address - Phone:410-952-2207
Mailing Address - Fax:
Practice Address - Street 1:1508 SPRINGDELL CIR
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-9632
Practice Address - Country:US
Practice Address - Phone:410-952-2207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-04
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12877568-2501103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical