Individual
JILLIAN BROECKERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCMHC
Contact information
Practice address
1420 W 360 N, SAINT GEORGE, UT 84770-4653
(435) 359-6798
Mailing address
1420 W 360 N, SAINT GEORGE, UT 84770-4653
(435) 359-6798
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
8390625-6004
UT
Other
Enumeration date
01/06/2016
Last updated
01/06/2016
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