Individual
KENNETH EUGENE THEVENIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
50 E NORTH TEMPLE FL 8, SALT LAKE CITY, UT 84150-4412
(806) 401-4661
Mailing address
50 E NORTH TEMPLE FL 8, SALT LAKE CITY, UT 84150-4412
(806) 401-4661
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
282730-3902
UT
Other
Enumeration date
08/12/2006
Last updated
08/12/2019
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