Individual
KENNETH JEPPESEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AMFT
Contact information
Practice address
3507 N UNIVERSITY AVE STE 350, PROVO, UT 84604-6602
(801) 477-0041
Mailing address
3507 N UNIVERSITY AVE STE 350, PROVO, UT 84604-6602
(801) 477-0041
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
6001151-3904
UT
Other
Enumeration date
06/23/2015
Last updated
06/23/2015
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