Individual
JACOB KENISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2046 E MURRAY HOLLADAY RD STE 101, HOLLADAY, UT 84117-5173
(801) 980-2566
Mailing address
5111 S 4620 W, KEARNS, UT 84118-5701
(917) 562-6141
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
05/15/2023
Last updated
05/15/2023
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