Organization
AGING CLINIC OF SOUTHERN UTAH PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIRSTEN LEIGH GRAHAM PHD (OWNER/PROVIDER)
(435) 277-0285
Entity
Organization
Contact information
Practice address
94 S 300 E, CEDAR CITY, UT 84720-3318
(435) 277-0285
Mailing address
94 S 300 E, CEDAR CITY, UT 84720-3318
(435) 277-0285
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
10/06/2023
Last updated
02/20/2024
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