Individual
MRS. KATHLEEN THERESA COUILLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
131 1ST AVE APT 706, SALT LAKE CITY, UT 84103-2314
(801) 824-2204
Mailing address
131 1ST AVE APT 706, SALT LAKE CITY, UT 84103-2314
(801) 824-2204
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
221231963501
UT
Other
Enumeration date
03/19/2007
Last updated
07/08/2007
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