Individual
CHEZLIE T JEDRZIEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1336 S 1100 E, SALT LAKE CITY, UT 84105-2421
(801) 251-6775
Mailing address
1543 E BROWNING AVE, SALT LAKE CITY, UT 84105-2701
(801) 414-6183
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
7474516-6004
UT
1041C0700X
Clinical Social Worker
74745166009
UT
Other
Enumeration date
05/05/2010
Last updated
05/27/2022
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