Individual
KELLY MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
449 E 2100 S, SALT LAKE CITY, UT 84115-2237
(801) 596-2111
(801) 359-3878
Mailing address
523 HERITAGE PARK BLVD, LAYTON, UT 84041-5711
(801) 525-9998
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
8978900-3501
UT
Other
Enumeration date
03/11/2019
Last updated
06/04/2021
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