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1053889501
JACOB K VICKREY
SOUTH JORDAN, UT
NPI
1053889501
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: UT 9742056-3501)
Enumeration Date
2018-11-02
Last Update Date
2024-08-16
Business Address
JACOB K VICKREY LCSW
11748 S 3600 W STE 3
SOUTH JORDAN, UT 84095-5922
Phone number: 801-896-8133
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Mailing Address
JACOB K VICKREY LCSW
14664 S WARD HILLS CIR
HERRIMAN, UT 84096-1256
Phone number: 760-792-3671
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