Individual
EMILEE SUE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
117 W 400 S, SALT LAKE CITY, UT 84101-1916
(801) 428-4257
Mailing address
117 W 400 S, SALT LAKE CITY, UT 84101-1916
(801) 428-4257
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
12/05/2013
Last updated
05/06/2024
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