Provider Demographics
NPI:1720105232
Name:ALBANESE, KERRIE H (LMFT)
Entity Type:Individual
Prefix:MS
First Name:KERRIE
Middle Name:H
Last Name:ALBANESE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9644 S 835 E
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84094-3565
Mailing Address - Country:US
Mailing Address - Phone:801-556-6975
Mailing Address - Fax:
Practice Address - Street 1:9710 S 700 E
Practice Address - Street 2:SUITE 114
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84070-3594
Practice Address - Country:US
Practice Address - Phone:801-569-2343
Practice Address - Fax:801-495-9547
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT349287-3902106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist