Individual
JAMIE KACZMAREK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1814 S LAKE ST, SALT LAKE CITY, UT 84105-3115
(801) 953-5846
Mailing address
1814 S LAKE ST, SALT LAKE CITY, UT 84105-3115
(801) 953-5846
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6688584-3501
UT
Other
Enumeration date
09/28/2023
Last updated
09/28/2023
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