Individual
TAYLOR JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2500 S STATE ST, SOUTH SALT LAKE, UT 84115-3164
(385) 646-5000
Mailing address
5522 S RIDGECREST DR, TAYLORSVILLE, UT 84129-7843
(801) 918-3939
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
—
—
Other
Enumeration date
06/02/2022
Last updated
06/02/2022
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