Individual
AMANDA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1660 W ANTELOPE DR STE 320, LAYTON, UT 84041-1172
(801) 773-4840
(801) 525-8151
Mailing address
PO BOX 337, LAYTON, UT 84041-0337
(801) 773-4840
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4959997-3501
UT
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
08/04/2017
Last updated
02/07/2023
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