Jade Pack

NPI #1104247204 in Provo, Utah

Provider Information

NPI Number: 1104247204
Entity Type: Individual
Name: Jade Pack
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker
Enumeration Date: Dec 17, 2013
Last Updated: Dec 17, 2013

Practice Location

Address: 750 N FREEDOM BLVD
City: Provo
State: Utah
ZIP Code: 84601-1677
Phone: (801) 373-4760

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker	104100000X	Primary

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