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Individual

ANDREA ELAINE JORGENSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S.

Contact information

Practice address
1400 N 500 E, LOGAN, UT 84341-2455
(435) 716-1000
Mailing address
309 E 700 N APT 2, LOGAN, UT 84321-3376
(801) 808-6287

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
9246477-4102
UT

Other

Enumeration date
07/26/2016
Last updated
07/26/2016
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