Provider Demographics
NPI:1760759625
Name:VEEDER, MARIETTA ANNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARIETTA
Middle Name:ANNE
Last Name:VEEDER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3540 W 2600 N
Mailing Address - Street 2:
Mailing Address - City:BENSON
Mailing Address - State:UT
Mailing Address - Zip Code:84335-9749
Mailing Address - Country:US
Mailing Address - Phone:435-770-0937
Mailing Address - Fax:
Practice Address - Street 1:3540 W 2600 N
Practice Address - Street 2:
Practice Address - City:BENSON
Practice Address - State:UT
Practice Address - Zip Code:84335-9749
Practice Address - Country:US
Practice Address - Phone:435-770-0937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-21
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist