Individual
MR. DEAN M KENNINGTON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
7434 S STATE ST, MIDVALE, UT 84047-2014
(801) 566-4423
Mailing address
9314 ALVEY LN, SANDY, UT 84093-2662
(801) 942-0098
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
118629-3501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107001380101
INTRMTN.HEALTHCARE
UT
01
—
20793
DESERET MUTUAL
UT
01
—
R79756
MEDICAR ADVANTAGE PLANS
UT
Enumeration date
12/15/2005
Last updated
07/08/2007
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