Individual
KIMBERLY DAWN PERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SSW
Contact information
Practice address
1109 E 360 S, PROVO, UT 84606-5253
(801) 357-9018
Mailing address
1109 E 360 S, PROVO, UT 84606-5253
(801) 357-9018
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/06/2008
Last updated
08/01/2013
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