Individual
MISS CHRISTIN LEIGH JACKETTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1338 MOSSY SPRINGS LN, HOLLADAY, UT 84117-4731
(801) 915-3892
Mailing address
1338 MOSSY SPRINGS LN, HOLLADAY, UT 84117-4731
(801) 915-3892
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
49884373501
UT
1041S0200X
School Social Worker
—
—
Other
Enumeration date
04/21/2008
Last updated
04/21/2008
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