Provider Demographics
NPI:1972388486
Name:AYALA-SANCHEZ, JENNIFER MICAELA (MSW)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MICAELA
Last Name:AYALA-SANCHEZ
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4702 N LONG WAY
Mailing Address - Street 2:
Mailing Address - City:EAGLE MOUNTAIN
Mailing Address - State:UT
Mailing Address - Zip Code:84005-2015
Mailing Address - Country:US
Mailing Address - Phone:801-928-3675
Mailing Address - Fax:
Practice Address - Street 1:118 E THRIVE DR
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:UT
Practice Address - Zip Code:84045-5550
Practice Address - Country:US
Practice Address - Phone:801-407-1599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-31
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13450750-35021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical