Individual
KAYLA BLICKENSDERFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1052 E BARBARA PL, SALT LAKE CITY, UT 84102-3111
(605) 786-4904
Mailing address
1052 E BARBARA PL, SALT LAKE CITY, UT 84102-3111
(605) 786-4904
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/02/2022
Last updated
06/02/2022
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