IndividualActive
Heather Jackson
NPI 1720863764 · Developmentally Disabled Services Day Training Agency · Provo, UT
Provider details
- NPI number
- 1720863764
- Entity type
- Individual
- Primary specialty
- Developmentally Disabled Services Day Training AgencyAgencies
- Sex
- Female
- Sole proprietor
- Yes
- License
- F23-104260 (UT)
Specialties & taxonomies
Agencies
Practice location
1200 Towne Centre Blvd Spc 1142
Provo, UT 84601-2941
Phone: (972) 658-4509
Approximate (ZIP-level) locationGet directions
Mailing address
312 Meadowlark Dr
Alpine, UT 84004-1371
Registry dates
- Enumerated
- 2023-08-29
- Last updated
- 2023-08-29
- Certified
- 2023-08-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.