Individual
KRISTINA L KELLY ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1086 E HIGHWAY 193 STE 103, LAYTON, UT 84040-8589
(801) 336-8475
Mailing address
306 N 1500 E, LAYTON, UT 84040-4558
(801) 336-8475
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5059033-3502
UT
Other
Enumeration date
02/21/2012
Last updated
07/16/2015
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