Healthcare Provider Details

I. General information

NPI: 1053223149
Provider Name (Legal Business Name): JENNIFER LYNN ZOOK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1034 RSI DR
LOGAN UT
84321-2203
US

IV. Provider business mailing address

321 E 9500 S
PARADISE UT
84328-8903
US

V. Phone/Fax

Practice location:
  • Phone: 435-799-9812
  • Fax:
Mailing address:
  • Phone: 435-764-5401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: