JACOB LYLE HERETH

SALT LAKE CITY, UT
NPI1598240947
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy104100000X Social Worker
Additional Taxonomies172V00000X Community Health Worker
Enumeration Date2018-10-02
Last Update Date2021-01-07
Business Address
JACOB LYLE HERETH
4460 S HIGHLAND DR STE 300
SALT LAKE CITY, UT 84124-3562
Phone number: 888-949-4864
Mailing Address
JACOB LYLE HERETH
4460 S HIGHLAND DR
SALT LAKE CITY, UT 84124-3543
Phone number: 888-949-4864