| NPI | 1376996421 |
|---|---|
| Other Name | NICKY JARDINE |
| Entity Type | Organization |
| Authorized Contact | NICHOLE L JARDINE Owner 435-213-3583 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 8977595-3501) |
| Enumeration Date | 2016-07-13 |
| Last Update Date | 2022-08-22 |