Individual
MR. JACOB BRYSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
150 E 700 S, SALT LAKE CITY, UT 84111-3806
(801) 364-8080
Mailing address
150 E 700 S, SALT LAKE CITY, UT 84111-3806
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
9665943-3905
UT
Other
Enumeration date
11/01/2016
Last updated
11/01/2016
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