Individual
JERICHO BRENT AVERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSW, CSUDC
Contact information
Practice address
20 S STATE ST, LINDON, UT 84042-1939
(801) 441-7144
Mailing address
2214 E LOCH LOMOND DR, SARATOGA SPRINGS, UT 84043-3911
(385) 374-9708
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
10395960-3502
UT
Other
Enumeration date
06/03/2019
Last updated
01/12/2023
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