Provider Demographics
NPI:1912624933
Name:DEFRIEZ, JANIE (LCGC)
Entity Type:Individual
Prefix:
First Name:JANIE
Middle Name:
Last Name:DEFRIEZ
Suffix:
Gender:F
Credentials:LCGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10948 S PADDLE BOARD WAY
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84009-1319
Mailing Address - Country:US
Mailing Address - Phone:972-310-2333
Mailing Address - Fax:
Practice Address - Street 1:1152 E 200 N
Practice Address - Street 2:
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-2004
Practice Address - Country:US
Practice Address - Phone:801-855-4112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-20
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12921097-3601170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS