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NPI Code Detail

MEDICARE: KELSEY LYTHGOE MSWI

MEDICARE: KELSEY LYTHGOE MSWI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker

General Provider Information

NPI Number : 1346003597
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELSEY LYTHGOE MSWI
Provider Business Mailing Address
First Line : 1570 S 1100 E
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84105-2441
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1570 S 1100 E
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84105-2441
Country : US
Telephone Number : 801-438-6387
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2024
Last Update Date : 01/31/2024

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Directions to “ KELSEY LYTHGOE MSWI” Practice Location

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