Kylie Lyn Stidham
Counselor in Salt Lake City, UT. Individual provider (NPI-1).
NPI number1144528811
StatusActive
Last updated in NPPESJun 29, 2022
Details
- NPI
- 1144528811
- Entity type
- Individual (NPI-1)
- Name
- Kylie Lyn Stidham
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 4, 2011
- Certification date
- Jun 29, 2022
- Last updated
- Jun 29, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101Y00000X | Counselor | – | – | Yes |
Practice location
5965 S 900 ESalt Lake City, UT 84121-1720
Phone 801-263-7100
Mailing address
5965 S 900 ESalt Lake City, UT 84121-1720
Phone 801-263-7100
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