Individual
KYLEIGH MICKOLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1009 E MURRAY HOLLADAY RD, MILLCREEK, UT 84117-4921
(801) 263-7115
Mailing address
3725 W 4100 S STE 201, WEST VALLEY CITY, UT 84120-5427
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
F24-114852
UT
172V00000X
Community Health Worker
—
UT
Other
Enumeration date
04/08/2024
Last updated
09/05/2024
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