Provider Demographics
NPI:1760299044
Name:KINDER, KYLEE
Entity type:Individual
Prefix:
First Name:KYLEE
Middle Name:
Last Name:KINDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3450 W 7900 S
Mailing Address - Street 2:
Mailing Address - City:BENJAMIN
Mailing Address - State:UT
Mailing Address - Zip Code:84660-4042
Mailing Address - Country:US
Mailing Address - Phone:385-539-8088
Mailing Address - Fax:
Practice Address - Street 1:475 W 260 N
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-1970
Practice Address - Country:US
Practice Address - Phone:385-539-8088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-11
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician