Most Relevant Information
Provider Data
| NPI Number: | 1003268335 |
| Provider Name: | KELLEY DIANE IRMEN |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | 10074151-3502 |
Most Important Dates
| Enumeration Date: | 07/11/2016 |
| Last Updated: | 02/26/2018 |
Provider Practice Location
934 S MAIN ST
LAYTON
UT
840417135
Practice Location Phone/Fax
| Phone: | 8017737060 |
| Fax: |
Provider Mailing Location
934 S MAIN ST
LAYTON
UT
840417135
Provider Mailing Phone/Fax
| Phone: | 8017737060 |
| Fax: |