Provider Demographics
NPI:1801838602
Name:LLEWELYN, RONNIE JAMES (PSYD)
Entity Type:Individual
Prefix:DR
First Name:RONNIE
Middle Name:JAMES
Last Name:LLEWELYN
Suffix:
Gender:M
Credentials:PSYD
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Mailing Address - Street 1:135 EAST WASATCH POINT LN
Mailing Address - Street 2:#27-101
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020
Mailing Address - Country:US
Mailing Address - Phone:858-775-6516
Mailing Address - Fax:
Practice Address - Street 1:660 S 200 E
Practice Address - Street 2:SUITE 308
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84111-3835
Practice Address - Country:US
Practice Address - Phone:801-355-2846
Practice Address - Fax:801-359-3244
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-13
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT6209081-2504103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical