Individual
JESSICA J CLEEVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
466 S 500 E # 200, SALT LAKE CITY, UT 84102-2705
(801) 449-0454
Mailing address
1953 S 1100 E UNIT 521124, SALT LAKE CITY, UT 84152-5064
(801) 449-0454
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
11388808-3502
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
—
Enumeration date
06/28/2021
Last updated
06/28/2021
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