Kim Mann | Salt Lake City, UT • PECOS Search

Kim Mann

Social Worker

Behavioral Health & Social Service Providers

5800 Highland Dr, Salt Lake City, UT 84121-1359

PECOS Enrollment

Based on the most recent information from CMS, provider Kim Mann does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1376869636
Provider Type
Individual
Full Name
Mann, Kim
Credential
LCSW

Gender
Female
Sole Proprietor
No
Enumeration Date
4/12/2010
Last Updated
9/25/2012

Contact Information

Practice Location

5800 Highland Dr, Salt Lake City, UT 84121-1359

Unlisted Fax

Mailing Location

5800 Highland Dr, Salt Lake City, UT 84121-1359

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 5984542-3502 Utah