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Individual

KYLENE SHIELDS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
600 S GENEVA RD, OREM, UT 84058-5803
(860) 987-8020
(860) 987-8020
Mailing address
746 N COULSON DR, LINDON, UT 84042-2558
(801) 830-3021

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
9016760-3501
UT

Other

Enumeration date
09/08/2017
Last updated
09/08/2017
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