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Individual

JARED D FERGUSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
411 N GRANT ST, SALT LAKE CITY, UT 84116-2725
(801) 359-8862
Mailing address
4095 S OLYMPIC WAY, SALT LAKE CITY, UT 84124-2125
(801) 332-9253

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6160923-3502
UT

Other

Enumeration date
06/04/2009
Last updated
01/08/2013
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