Individual
MRS. JAQUELINE PACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1466 N HIGHWAY 89 STE 220, FARMINGTON, UT 84025-2738
(801) 451-0475
Mailing address
273 N 2975 W, LAYTON, UT 84041-8835
(801) 628-6344
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3158913501
UT
Other
Enumeration date
01/11/2007
Last updated
07/08/2007
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