Individual
KYLE PATTERSON MAMMEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
372 N 650 W, SPRINGVILLE, UT 84663-5620
(801) 499-0520
Mailing address
372 N 650 W, SPRINGVILLE, UT 84663-5620
(801) 499-0520
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
8720265-6004
UT
Other
Enumeration date
12/22/2020
Last updated
12/22/2020
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