Individual
PAUL JACKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, AMFT
Contact information
Practice address
2994 S GOULD WASH RD, HURRICANE, UT 84737
(435) 635-0636
Mailing address
1500 E 2700 S, HURRICANE, UT 84737-4000
(435) 669-1948
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
10100228-3904
UT
Other
Enumeration date
10/27/2017
Last updated
10/27/2017
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