Individual
JARED RANDALL JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1085 S BLUFF ST BSMT, ST GEORGE, UT 84770-5245
(435) 674-9999
Mailing address
325 S 200 E APT 2, ST GEORGE, UT 84770-3649
(435) 674-9999
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
F22-101891
UT
175T00000X
Peer Specialist
F23-108644
UT
Other
Enumeration date
10/06/2025
Last updated
10/06/2025
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