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General NPI Number Information
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NPI Number | 1609477819
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Entity Type | Individual
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Provider Name | JAIMEE L CHARLESWORTH BS, CSW
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Gender | Female
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Dates
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Enumeration Date | 11/04/2020
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 172 N EAST PROMONTORY STE 270
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City | FARMINGTON
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State | UT
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Zip | 84025-2964
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Country | US
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Telephone | 801-940-5184
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Fax |
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Provider Business Mailing Address
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Address Line | 1965 HERITAGE PKWY
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City | SYRACUSE
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State | UT
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Zip | 84075-7063
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Country | US
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Telephone | 801-628-0414
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Fax | 801-683-8962
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 14015801-3502
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License Number State |
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