Individual
KIMBERLY SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
623 E 100 S, SALT LAKE CITY, UT 84102-1103
(801) 979-1351
Mailing address
6773 DAWN VISTA RD, WEST JORDAN, UT 84081-3415
(801) 518-5620
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
52199593502
UT
Other
Enumeration date
02/10/2012
Last updated
02/10/2012
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