Provider Demographics
NPI:1457872079
Name:DUFFIN, JENNIFER P (CMHC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:P
Last Name:DUFFIN
Suffix:
Gender:F
Credentials:CMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3281 N 425 W
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043
Mailing Address - Country:US
Mailing Address - Phone:801-735-2301
Mailing Address - Fax:
Practice Address - Street 1:2700 HOMESTEAD RD STE 210
Practice Address - Street 2:
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84098-4858
Practice Address - Country:US
Practice Address - Phone:801-753-8771
Practice Address - Fax:801-295-2841
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-05
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
UT10846476-6004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health