Individual
JENNELL NICOLE MAUNDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.S.
Contact information
Practice address
151 S UNIVERSITY AVE, PROVO, UT 84601-4427
(801) 851-7127
Mailing address
151 S UNIVERSITY AVE, PROVO, UT 84601-4427
(801) 851-7127
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
104100000X
Social Worker
Primary
9567889-3503
UT
Other
Enumeration date
07/16/2013
Last updated
06/09/2016
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