Individual
TY JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ASUDC
Contact information
Practice address
3570 S WEST TEMPLE, SOUTH SALT LAKE, UT 84115-4408
(801) 533-0070
Mailing address
3570 S WEST TEMPLE, SOUTH SALT LAKE, UT 84115-4408
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
13440516-6008
UT
Other
Enumeration date
09/18/2025
Last updated
09/18/2025
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