MR. BRENT JACKSON
Counselor
Active
Individual
NPI: 1063790921
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Counselor | 101Y00000X | Yes | - |
Frequently Asked Questions
NPI 1063790921 is the National Provider Identifier for MR. BRENT JACKSON, a Counselor provider located in Salt Lake City, UT. This NPI was enumerated on July 26, 2011.
MR. BRENT JACKSON practices at 5965 S 900 E, Salt Lake City, UT 84121.
Quick Facts
- NPI
- 1063790921
- Type
- Individual
- Enumerated
- Jul 26, 2011
- Last Updated
- Jul 26, 2011
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