JEREMIAH SOUTHWORTH

Counselor - Mental Health

Active Individual
NPI: 1104223593

Practice Address

750 N FREEDOM BLVD
Provo, UT 84601

Phone: (801) 373-4760

Specialties

Specialty Code Primary License
Peer Specialist 175T00000X No -
Counselor - Mental Health 101YM0800X Yes -

Frequently Asked Questions

NPI 1104223593 is the National Provider Identifier for JEREMIAH SOUTHWORTH, a Counselor - Mental Health provider located in Provo, UT. This NPI was enumerated on December 1, 2014.
JEREMIAH SOUTHWORTH practices at 750 N FREEDOM BLVD, Provo, UT 84601.

Quick Facts

NPI
1104223593
Type
Individual
Enumerated
Dec 1, 2014
Last Updated
May 7, 2020

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