Provider Demographics
NPI:1992942247
Name:THOMLINSON, JENNIFER J (CSW)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:J
Last Name:THOMLINSON
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3392 W 3500 S
Mailing Address - Street 2:
Mailing Address - City:WEST VALLEY
Mailing Address - State:UT
Mailing Address - Zip Code:84119-2630
Mailing Address - Country:US
Mailing Address - Phone:801-969-3307
Mailing Address - Fax:801-964-8898
Practice Address - Street 1:3392 W 3500 S
Practice Address - Street 2:
Practice Address - City:WEST VALLEY
Practice Address - State:UT
Practice Address - Zip Code:84119-2630
Practice Address - Country:US
Practice Address - Phone:801-969-3307
Practice Address - Fax:801-964-8898
Is Sole Proprietor?:No
Enumeration Date:2009-01-08
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2930743502101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health