Individual
KYLEE JASPER HOLLENBACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
437 W 1155 N, LOGAN, UT 84341-6995
(801) 403-8675
Mailing address
437 W 1155 N, LOGAN, UT 84341-6995
(801) 403-8675
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
12298207-3501
UT
Other
Enumeration date
06/29/2016
Last updated
07/30/2025
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