Individual
MS. KATHLEEN KALOUDIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCMHC
Contact information
Practice address
7105 S HIGHLAND DR STE 202, SALT LAKE CITY, UT 84121-7321
(801) 201-7050
(801) 880-1508
Mailing address
PO BOX 71051, SALT LAKE CITY, UT 84171-0051
(801) 201-7050
(801) 880-1508
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
17837
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
158041701
MEDICAID
TX
05
—
158041702
—
TX
Enumeration date
10/12/2006
Last updated
02/10/2022
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