Individual
KILEY MCCALL KIDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
719 N 1890 W # 38B, PROVO, UT 84601-1333
(559) 679-1617
Mailing address
1733 W 550 N, LINDON, UT 84042-1514
(559) 679-1617
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
10187476-3502
UT
Other
Enumeration date
04/13/2019
Last updated
04/13/2019
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