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General NPI Number Information
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NPI Number | 1679393953
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Entity Type | Individual
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Provider Name | JENNIFER SPIETH CSW
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Gender | Female
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Dates
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Enumeration Date | 10/12/2024
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Last Update Date | 10/12/2024
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Provider Practice Location Address
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Address Line | 375 N MAIN ST
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City | KAYSVILLE
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State | UT
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Zip | 84037-1199
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Country | US
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Telephone | 801-989-3488
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Fax |
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Provider Business Mailing Address
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Address Line | 293 N 200 E APT A
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City | FARMINGTON
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State | UT
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Zip | 84025-2553
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Country | US
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Telephone | 503-475-0609
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 13991355-3502
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License Number State | UT
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