Kylin Long
Individual provider Active NPI Speech-Language Pathologist · Clinton, UT
NPI 1669836839 · NPPES record last updated May 31, 2022
Key facts
- NPI
- 1669836839
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 12730379-4104 (UT)
- Practice address
- 1558 N 550 W
Clinton, UT 84015-9506 - Phone
- (801) 927-7078
- NPI assigned
- Apr 13, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12730379-4104 | UT | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bridgeway Integrated Healthcare Services Inc | Counselor | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Speech-Language Pathologist | 235Z00000X | 12730379-4104 | UT | Yes |
Addresses
Primary practice location
1558 N 550 W
Clinton, UT 84015-9506
Mailing address
6013 S Redwood Rd
Taylorsville, UT 84123-5220
Phone (801) 255-5131
Other providers in Clinton, UT
- Samantha Knuth
- Devan Bradley Kunzler
- Joseph Patrick Lamb
- Ryan Lindquist
- Living Wright Recovery
- Kirt Dallas Longfellow
- Cassie Lopez
- Tyler Martineau
- Ann Maruri
- Joseph Karl McCombs
All providers in Clinton, UT · Speech-Language Pathologist in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 31, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.