Individual
MADELINE JENNIFER THORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4625 S 2300 E, SALT LAKE CITY, UT 84117-4583
(801) 865-1453
Mailing address
836 E 480 S, AMERICAN FORK, UT 84003-4266
(915) 274-2358
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
134591113502
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
134591113502
LICENSE
UT
Enumeration date
06/03/2025
Last updated
06/03/2025
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