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Individual

JEREMY DALLAS ANDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
780 S 2000 W STE E302, SYRACUSE, UT 84075-9611
(801) 896-3622
Mailing address
210 N 3600 W, LAYTON, UT 84041-7114
(801) 628-0113

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
14191462-3904
UT

Other

Enumeration date
11/15/2024
Last updated
11/15/2024
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