Individual
JACOB HOLBROOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
934 S MAIN ST, LAYTON, UT 84041-7135
(801) 773-7060
Mailing address
5125 S 1500 W, RIVERDALE, UT 84405-3926
(801) 719-7603
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6967058-3503
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1225413586
PRIVATE PRACTICE NON MEDICAID
UT
Enumeration date
07/28/2015
Last updated
11/15/2022
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