Provider Demographics
NPI:1225488919
Name:BROWER, JENNY
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:
Last Name:BROWER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:459 S 875 E
Mailing Address - Street 2:
Mailing Address - City:KAYSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84037-2663
Mailing Address - Country:US
Mailing Address - Phone:801-628-0426
Mailing Address - Fax:
Practice Address - Street 1:459 S 875 E
Practice Address - Street 2:
Practice Address - City:KAYSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84037-2663
Practice Address - Country:US
Practice Address - Phone:801-628-0426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-14
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5505724-2507106E00000X
172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No172V00000XOther Service ProvidersCommunity Health Worker