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Individual
KENNETH JOEL ALLRED
Active
Individual
KENNETH JOEL ALLRED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
197117-3503
UT
1041C0700X
Clinical Social Worker
Primary
197117-3501
UT
164W00000X
Licensed Practical Nurse
197117-3101
UT
Other
Enumeration date
07/25/2006
Last updated
10/24/2013
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