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General NPI Number Information
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NPI Number | 1740508597
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Entity Type | Individual
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Provider Name | KIMBERLY MARTIN LMFT
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Gender | Female
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Dates
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Enumeration Date | 05/04/2010
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Last Update Date | 04/13/2022
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Provider Practice Location Address
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Address Line | 1175 E 3200 N
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City | LEHI
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State | UT
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Zip | 84043-5464
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Country | US
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Telephone | 385-352-3738
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Fax |
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Provider Business Mailing Address
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Address Line | 121 W 640 N
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City | AMERICAN FORK
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State | UT
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Zip | 84003-1579
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Country | US
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Telephone | 801-376-9293
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 52048383902
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License Number State | UT
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