Individual
JACOB BRUSHABER-DROCKTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
350 S 400 E, SALT LAKE CITY, UT 84111-2905
(801) 582-5534
(801) 582-5540
Mailing address
350 S 400 E, SALT LAKE CITY, UT 84111-2905
(801) 582-5534
(801) 582-5540
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
08/13/2019
Last updated
08/13/2019
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