Individual
JESSICA WALTERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
1355 N MAIN ST STE 6, BOUNTIFUL, UT 84010-5982
(801) 513-1727
Mailing address
3413 W 1340 N, CLINTON, UT 84015-7531
(435) 512-1791
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
12890360-3502
UT
106S00000X
Behavior Technician
—
—
Other
Enumeration date
08/24/2017
Last updated
07/01/2024
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