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Individual

JON NATHAN JENSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CMHC

Contact information

Practice address
1025 W 450 N, PROVO, UT 84601-2518
(801) 812-1473
Mailing address
1025 W 450 N, PROVO, UT 84601-2518
(801) 812-1473

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
291140-6004
UT
101YM0800X
Mental Health Counselor
291140-6004
UT

Other

Enumeration date
09/29/2020
Last updated
10/05/2020
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