Individual
MERRILL KINGSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
5770 S 1500 W, SALT LAKE CITY, UT 84123-5216
(801) 265-3000
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 265-3000
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1154122501
UT
Other
Enumeration date
07/21/2006
Last updated
10/16/2007
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