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Individual

JACKIE P. RODAT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMFT

Contact information

Practice address
9192 S 300 W STE 19, SANDY, UT 84070-2673
(801) 792-3270
Mailing address
569 ALFRED WAY, SALT LAKE CITY, UT 84123-6523
(801) 792-3270

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
332068-3902
UT

Other

Enumeration date
01/18/2011
Last updated
02/19/2013
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