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1912977505
EVAN T KENISON
TOOELE, UT
NPI
1912977505
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: UT 3099283501)
Enumeration Date
2006-01-25
Last Update Date
2019-08-08
Business Address
Mr. EVAN T KENISON LCSW
100 S 1000 W
TOOELE, UT 84074-4010
Phone number: 435-843-3520
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Mailing Address
Mr. EVAN T KENISON LCSW
PO BOX 751
TOOELE, UT 84074-0751
Phone number: 435-850-2547
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