Individual
JEDEDIAH RUSHFORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
5770 S 1500 W, SALT LAKE CITY, UT 84123-5216
(801) 313-7770
(801) 313-7771
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6620938-3501
UT
Other
Enumeration date
08/06/2019
Last updated
05/22/2025
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