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Individual

KIMBERLY NELSON PARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CSW

Contact information

Practice address
1760 W 4805 S, TAYLORSVILLE, UT 84118-1177
(801) 955-9110
Mailing address
1155 E 2100 S, APT 728, SALT LAKE CITY, UT 84106-2872
(801) 510-3966

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
7290402-3502
UT

Other

Enumeration date
05/22/2009
Last updated
05/22/2009
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