Provider Demographics
NPI:1942996111
Name:JACOB, APRIL JEAN
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:JEAN
Last Name:JACOB
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 1:2787 S SPRING MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:UT
Mailing Address - Zip Code:84045-6668
Mailing Address - Country:US
Mailing Address - Phone:801-368-6301
Mailing Address - Fax:
Practice Address - Street 1:3740 WEST MARKET CENTER DRIVE
Practice Address - Street 2:#1200
Practice Address - City:RIVERTON
Practice Address - State:UT
Practice Address - Zip Code:84065
Practice Address - Country:US
Practice Address - Phone:801-240-9436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-12
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor