Provider Demographics
NPI:1316793474
Name:KENT, ANN MICHELLE (LMFT)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:MICHELLE
Last Name:KENT
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 1:2563 E 1240 SOUTH CIR
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-5705
Mailing Address - Country:US
Mailing Address - Phone:435-767-1054
Mailing Address - Fax:
Practice Address - Street 1:736 S 900 E STE 203D
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-7000
Practice Address - Country:US
Practice Address - Phone:435-767-1054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12865172-3902106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist