Individual
MS. KIMBERLY ANN KETTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
7309 S 180 W, MIDVALE, UT 84047-1020
(801) 565-6812
(801) 569-9718
Mailing address
8937 S NORTH FORTY RD, SANDY, UT 84093-1726
(801) 944-3408
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
316386-3501
UT
Other
Enumeration date
01/18/2006
Last updated
07/08/2007
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