MEDICARE: KIARA TREJO

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
1	1041C0700X	Clinical Social Worker	12900564-3501	UT

General Provider Information

NPI Number	:	1437970829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIARA TREJO

Provider Business Mailing Address
First Line	:	453 S OREM BLVD APT 28
Second Line	:
City	:	OREM
State	:	UT
Zip	:	84058-3112
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2945 E TURNING POINT CIR
Second Line	:
City	:	SANDY
State	:	UT
Zip	:	84092-1204
Country	:	US
Telephone Number	:	801-576-0745
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/18/2024
Last Update Date	:	10/18/2024

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Directions to “ KIARA TREJO ” Practice Location

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