Individual
JARED GREENE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
50 S MAIN ST STE 21, MANTI, UT 84642-1378
(435) 851-9126
Mailing address
545 N 500 W, MANTI, UT 84642-1041
(435) 851-9126
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1
—
UT
Enumeration date
06/08/2011
Last updated
03/22/2019
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