Individual
TARA JORGENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
50 N MEDICAL DR # 1R101, SALT LAKE CITY, UT 84132-0001
(801) 581-2619
Mailing address
6588 JEFFERSON ST, MURRAY, UT 84107-7014
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6524452-4102
UT
Other
Enumeration date
05/15/2007
Last updated
07/08/2007
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