Individual
C KAI MEDINA MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
33 S MAIN ST # 2A, BRIGHAM CITY, UT 84302-2668
(801) 467-2072
Mailing address
33 S MAIN ST # 2A, BRIGHAM CITY, UT 84302-2668
(801) 556-7762
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
310922-3501
UT
Other
Enumeration date
12/21/2006
Last updated
08/15/2024
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