Individual
KEVIN MICHAEL FENSTERMACHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1549 E 3970 S, MILLCREEK, UT 84124-1524
(801) 201-3139
Mailing address
1549 E 3970 S, MILLCREEK, UT 84124-1524
(801) 201-3139
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
5075655-2501
UT
Other
Enumeration date
01/30/2019
Last updated
01/30/2019
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