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Contact Information

HEATHER K JACKSON
1200 TOWNE CENTRE BLVD SPC 1142
PROVO, UT84601-2941
 Phone: 972-658-4509
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Day Training, Developmentally Disabled Services

251C00000X
Indicates primary specialty

NPI Profile & details for HEATHER K JACKSON · (Female)

NPI Number 1720863764
Status Active
Credentials
Entity Individual
Enumeration date 08/29/2023
Last updated 08/29/2023 - About 3 years ago
Sole proprietor 1 Yes
Identifiers
  • UT License # F23-104260
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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