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NPI Code Detail

MEDICARE: KENDRA LARA PARRY CSW

MEDICARE: KENDRA LARA PARRY CSW
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
11041C0700XClinical Social Worker14239345-3502UT

General Provider Information

NPI Number : 1952232746
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENDRA LARA PARRY CSW
Provider Business Mailing Address
First Line : 6864 N SNIVELY CT
Second Line :
City : TOOELE
State : UT
Zip : 84074-5401
Country : US
Telephone Number : 208-970-2045
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 : 385-786-0722
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2026
Last Update Date : 05/28/2026

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Directions to “ KENDRA LARA PARRY CSW” Practice Location

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