Individual
KEELEY JEAN MENDENHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
675 E 500 S, STE 300, SLC, UT 84102-2818
(801) 662-3606
Mailing address
675 E. 500 S., STE 300, SLC, UT 84102
(801) 662-3606
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
5733523-3502
UT
Other
Enumeration date
01/14/2009
Last updated
01/14/2009
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