Individual
KENNEDY GARLAND JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12595 S MINUTEMAN DR, DRAPER, UT 84020-9541
(801) 882-2618
(801) 882-2618
Mailing address
1488 HCR 3320, HUBBARD, TX 76648-4791
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
114219
TX
1041C0700X
Clinical Social Worker
Primary
14190701-3501
UT
Other
Enumeration date
06/29/2026
Last updated
06/29/2026
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