Provider Demographics
NPI:1548589179
Name:JARAMILLO, LEAH E (CMFTI)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:E
Last Name:JARAMILLO
Suffix:
Gender:F
Credentials:CMFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1481 REDONDO AVE
Mailing Address - Street 2:
Mailing Address - City:SLC
Mailing Address - State:UT
Mailing Address - Zip Code:84105-3709
Mailing Address - Country:US
Mailing Address - Phone:801-414-0596
Mailing Address - Fax:
Practice Address - Street 1:340 E 100 S
Practice Address - Street 2:
Practice Address - City:SLC
Practice Address - State:UT
Practice Address - Zip Code:84111-1702
Practice Address - Country:US
Practice Address - Phone:801-428-3453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-21
Last Update Date:2010-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist