Individual
MR. PETER JAY ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
283 N 300 W STE 501, KAYSVILLE, UT 84037-1881
(801) 759-7103
Mailing address
283 N 300 W STE 501, KAYSVILLE, UT 84037-1881
(801) 759-7103
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
6217446-3501
UT
101YP2500X
Professional Counselor
6217446-3501
UT
1041C0700X
Clinical Social Worker
Primary
6217446-3501
UT
Other
Enumeration date
03/06/2023
Last updated
03/06/2023
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