Individual
ELAINE MCKIBBIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
344 E 100 S STE 301, SALT LAKE CITY, UT 84111-1727
(801) 428-4257
Mailing address
380 S 400 E APT 427, SALT LAKE CITY, UT 84111-2933
(435) 901-3921
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
02/01/2022
Last updated
02/01/2022
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