Individual
MR. GERALD ELDRIDGE KAWIKA ALLEN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.S.
Contact information
Practice address
8184 HIGHLAND DR, SANDY, UT 84093-6477
(801) 944-1666
(801) 944-1698
Mailing address
1355 CEDAR CREST DR, SANDY, UT 84092-2923
(801) 733-5190
(801) 944-1698
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5055381-6009
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000000000000
—
UT
Enumeration date
04/05/2006
Last updated
07/08/2007
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