Individual
JESSICA LOUIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
62 E 2700 S, SOUTH SALT LAKE, UT 84115-3132
(801) 477-4480
Mailing address
62 E 2700 S, SOUTH SALT LAKE, UT 84115-3132
(801) 477-4480
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
4859690-6006
UT
Other
Enumeration date
08/17/2017
Last updated
05/18/2023
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