Individual
RICKIE LEE JORGENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
363 N FOOTHILL DR, CEDAR CITY, UT 84721-4005
(435) 669-3629
Mailing address
363 N FOOTHILL DR, CEDAR CITY, UT 84721-4005
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/06/2013
Last updated
09/06/2013
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