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Search › Utah › 101YM0800X

Jeremiah Southworth

NPI 1104223593 · on the registry since 2014 · sole proprietor

Practice

Address
750 N Freedom Blvd
Provo, UT 84601
Phone
(801) 373-4760
Fax
(801) 373-0639
Organisation at this address
Wasatch Mental Health
Wasatch Mental Health
Wasatch Mental Health
Wasatch Behavioral Health Special Service District
Inferred from a shared address, not stated in the registry.
Clinicians at this address
1,547

Registry record

Primary taxonomy
101YM0800X
101YM0800X
Also registered as
175T00000X
Sex
Male
Record last updated
2020-05-07

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Utah