Individual
JACKSON KIMBALL HOUMAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
870 W CENTER ST, OREM, UT 84057-5202
(801) 426-8800
Mailing address
870 W CENTER ST, OREM, UT 84057-5202
(801) 426-8800
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
12849314-3501
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/30/2021
Last updated
03/12/2024
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