| Kelley Diane Irmen, | |
|
934 S Main St, Layton, UT 84041-7135 | |
| (801) 773-7060 | |
| Not Available |
| Full Name | Kelley Diane Irmen |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 934 S Main St, Layton, Utah |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003268335 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 10074151-3502 (Utah) | Primary |
| Entity Name | Karen W. Malm, Ph.d., P.c. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1871701656 PECOS PAC ID: 4284732835 Enrollment ID: O20070723000349 |
| Mailing Address | Practice Location Address |
|---|---|
| Kelley Diane Irmen, 934 S Main St, Layton, UT 84041-7135 Ph: (801) 773-7060 | Kelley Diane Irmen, 934 S Main St, Layton, UT 84041-7135 Ph: (801) 773-7060 |
Michele Tanner, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 934 S Main St, Layton, UT 84041 Phone: 801-773-7060 | |
Jennifer Lynn Forbes, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 934 S Main St, Layton, UT 84041 Phone: 801-773-7060 | |
Curtis M. Tesch, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 934 S Main St, Layton, UT 84041 Phone: 801-773-7060 | |
Alison Coburn, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 1660 W Antelope Dr Ste 320, Layton, UT 84041 Phone: 801-773-4840 | |
Rod F Thornley, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 934 S Main St, Layton, UT 84041 Phone: 801-773-7060 | |
Emily Duffin, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 934 S Main St, Layton, UT 84041 Phone: 801-773-7060 |