Organization
NATHAN JACQUEZ CMHC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATHAN JACQUEZ CMHC (THERAPIST)
(801) 941-0364
Entity
Organization
Contact information
Practice address
455 E 200 S STE 110-D, SALT LAKE CITY, UT 84111-2157
(385) 206-6406
Mailing address
455 E 200 S STE 110-D, SALT LAKE CITY, UT 84111-2157
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/07/2023
Last updated
02/07/2023
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