Organization
KAIZEN CENTER FOR MENTAL HEALTH PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL WICKERSHAM (PROVIDER/OWNER)
(801) 712-1790
Entity
Organization
Contact information
Practice address
4055 S 700 E STE 103, MURRAY, UT 84107-2508
(801) 712-1790
Mailing address
4055 S 700 E STE 103, MURRAY, UT 84107-2508
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
94280933501
UT
Other
Enumeration date
04/18/2018
Last updated
04/18/2018
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