Individual
JEREMY JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
45 E. 100 S., CASTLEDALE, UT 84513
(435) 381-2432
(801) 373-0639
Mailing address
P.O. BOX 867, PRICE, UT 84501-0867
(435) 637-7200
(801) 373-0639
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
11450229-6009
UT
Other
Enumeration date
10/04/2016
Last updated
06/11/2021
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