Healthcare Provider Details

I. General information

NPI: 1922694819
Provider Name (Legal Business Name): JON AARON CALL LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2020
Last Update Date: 12/15/2020
Certification Date: 12/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1258 W SOUTH JORDAN PKWY STE 202
SOUTH JORDAN UT
84095-4712
US

IV. Provider business mailing address

7705 N KITTY HAWK WAY
EAGLE MOUNTAIN UT
84005-4312
US

V. Phone/Fax

Practice location:
  • Phone: 801-255-1155
  • Fax: 801-255-0281
Mailing address:
  • Phone: 801-921-9342
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number10836929-3904
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: