| Jackie Z Rock Llc | |
|
123 E Main St Sandy UT 84070-1509 | |
| (801) 448-7811 | |
| Not Available |
| Full Name | Jackie Z Rock Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 123 E Main St, Sandy, Utah |
| Authorized Official Name and Position | Jackie Z Rock (MENTAL HEALTH COUNSELOR) |
| Authorized Official Contact | 8014487811 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jackie Z Rock Llc 123 E Main St Sandy UT 84070-1509 Ph: (801) 448-7811 | Jackie Z Rock Llc 123 E Main St Sandy UT 84070-1509 Ph: (801) 448-7811 |
| NPI Number | 1730785940 |
|---|---|
| Provider Enumeration Date | 12/11/2020 |
| Last Update Date | 12/11/2020 |
| Certification Date | 12/11/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730785940 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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