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General NPI Number Information
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NPI Number | 1609760834
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Entity Type | Individual
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Provider Name | JESSICA DENARDO
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Gender | Female
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Dates
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Enumeration Date | 06/04/2025
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Last Update Date | 06/04/2025
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Provider Practice Location Address
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Address Line | 1206 W SOUTH JORDAN PKWY STE D
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City | SOUTH JORDAN
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State | UT
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Zip | 84095-5519
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Country | US
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Telephone | 801-302-3801
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Fax |
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Provider Business Mailing Address
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Address Line | 380 S 1500 W
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City | LEHI
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State | UT
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Zip | 84043-3627
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Country | US
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Telephone | 412-901-3913
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 116417216010
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License Number State | UT
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