Individual
JORDYNN MARIE GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSUDC
Contact information
Practice address
192 E 200 N STE 101, ST GEORGE, UT 84770-2834
(435) 610-1696
Mailing address
192 E 200 N STE 101, ST GEORGE, UT 84770-2834
(435) 610-1696
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
12403870-6005
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1780216507
—
UT
Enumeration date
12/08/2021
Last updated
12/08/2021
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