Individual
DR. KANDICE JACLYNN BENALLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
170 S 1000 E STE 201, SALT LAKE CITY, UT 84102-1403
(801) 419-0139
Mailing address
170 S 1000 E STE 201, SALT LAKE CITY, UT 84102-1403
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
13531066-2501
UT
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
13531066-2501
UT
Other
Enumeration date
08/07/2023
Last updated
03/07/2024
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