Healthcare Provider Details

I. General information

NPI: 1124717889
Provider Name (Legal Business Name): JACLYN CRAIG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2023
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

237 W 520 N
OREM UT
84057-4696
US

IV. Provider business mailing address

1164 S RAINTREE LN
SANTAQUIN UT
84655-8361
US

V. Phone/Fax

Practice location:
  • Phone: 801-642-4244
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: