Individual
LAUREN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5383 S 900 E STE 103, MURRAY, UT 84117-7266
(801) 872-5516
(801) 212-9942
Mailing address
750 N FREEDOM BLVD, PROVO, UT 84601-1677
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
12256132-3502
UT
1041C0700X
Clinical Social Worker
Primary
12256132-3502
UT
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
03/02/2019
Last updated
08/24/2021
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