Individual
KIMBERLEE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AMFT
Contact information
Practice address
3509 ADOBE DR, SANTA CLARA, UT 84765-5365
(435) 619-0137
Mailing address
1500 E 2700 S, HURRICANE, UT 84737-4000
(435) 635-0636
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
11784016-3904
UT
Other
Enumeration date
11/19/2020
Last updated
11/19/2020
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