JESSE WREN ELLIS

PROVO, UT
NPI1487165932
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: UT  7748699-3501)
Enumeration Date2017-10-23
Last Update Date2017-10-23
Business Address
Mr. JESSE WREN ELLIS LCSW
1157 N 300 W
PROVO, UT 84604-6124
Phone number: 801-357-7525
Mailing Address
Mr. JESSE WREN ELLIS LCSW
1034 N 500 W
PROVO, UT 84604-3380
Phone number: 801-357-8108
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