Individual
JACOB VON STUCKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
5284 S COMMERCE DR STE C134, MURRAY, UT 84107-5360
(801) 266-4643
Mailing address
756 E 500 S, SALT LAKE CITY, UT 84102-2906
(435) 590-0116
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
117820163502
UT
Other
Enumeration date
11/14/2018
Last updated
12/06/2022
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