Individual
JERRICA LAVOOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2150 S 1300 E STE 500, SALT LAKE CITY, UT 84106-4375
(385) 262-4048
Mailing address
829 E BRYAN AVE, SALT LAKE CITY, UT 84105-2214
(973) 525-8465
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
12326158-3501
UT
1041C0700X
Clinical Social Worker
12326158-3502
UT
Other
Enumeration date
08/26/2021
Last updated
01/16/2023
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