Individual
CAROLINE KELLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4465 S 900 E STE 150, MILLCREEK, UT 84124-3944
(435) 248-2089
Mailing address
4465 S 900 E STE 150, MILLCREEK, UT 84124-3944
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
10371472-6004
UT
Other
Enumeration date
11/18/2019
Last updated
11/18/2019
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