Individual
DOMINICK ANTONIO JEFFERIES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW, CSW
Contact information
Practice address
4609 S 2300 E, HOLLADAY, UT 84117-4527
(801) 461-9060
Mailing address
406 N MAIN ST, BOUNTIFUL, UT 84010-6035
(801) 859-8999
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
324500-3502
UT
Other
Enumeration date
02/16/2010
Last updated
02/16/2010
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