Individual
DR. JEFFREY BROWN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D., LMFT
Contact information
Practice address
450 N UNIVERSITY AVE, SUITE 204, PROVO, UT 84601-2860
(801) 815-8105
Mailing address
1372 N 1230 W, OREM, UT 84057-6512
(801) 815-8105
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
5731350-3902
UT
Other
Enumeration date
07/28/2009
Last updated
07/28/2009
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