Individual
MRS. JENNIFER LYNN THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1138 WILMINGTON AVE, SALT LAKE CITY, UT 84106-2819
(801) 581-2221
Mailing address
PO BOX 510721, SALT LAKE CITY, UT 84151-0721
(801) 587-6872
(801) 587-6675
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
335777-4201
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
335777-4201
PROFESSIONAL STATE LICENS
UT
Enumeration date
01/12/2007
Last updated
07/08/2007
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