Individual
MRS. JESSICA LACEY FISHER CHAMPLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.C.S.W.
Contact information
Practice address
1290 S 500 W STE 300, WOODS CROSS, UT 84010-8104
(801) 215-9575
(833) 904-1668
Mailing address
553 N 190 E, NORTH SALT LAKE, UT 84054-2200
(801) 215-9575
(833) 904-1668
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
10853410-3501
UT
Other
Enumeration date
03/24/2017
Last updated
06/06/2023
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