Organization
FENSTER CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN MICHAEL FENSTERMACHER PH.D. (PRESIDENT)
(801) 201-3139
Entity
Organization
Contact information
Practice address
4505 WASATCH BLVD STE 380, SALT LAKE CITY, UT 84124-4733
(801) 201-3139
Mailing address
4505 WASATCH BLVD STE 380, SALT LAKE CITY, UT 84124-4733
(801) 201-3139
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
5075655-2501
UT
Other
Enumeration date
12/11/2006
Last updated
08/22/2020
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