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General NPI Number Information
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NPI Number | 1407590755
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Entity Type | Individual
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Provider Name | KAYLA MICHELLE DENTER LCMHC
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Gender | Female
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Dates
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Enumeration Date | 04/22/2022
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Last Update Date | 04/22/2022
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Provider Practice Location Address
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Address Line | 1320 W SOUTH JORDAN PKWY
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City | SOUTH JORDAN
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State | UT
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Zip | 84095-8847
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Country | US
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Telephone | 801-709-0774
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Fax |
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Provider Business Mailing Address
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Address Line | 9132 S JEFFERSON PL BLDG 17
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City | SANDY
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State | UT
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Zip | 84070-6622
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Country | US
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Telephone | 801-635-9471
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 10852756-6004
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License Number State | UT
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