Individual
KEVIN THERIOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
132 S STATE ST, SALT LAKE CITY, UT 84111-1506
(801) 240-2429
Mailing address
9433 SUNSET RIDGE DR, SANDY, UT 84092-2505
(801) 432-7049
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW -0065
AZ
Other
Enumeration date
10/13/2006
Last updated
02/18/2011
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