Provider Demographics
NPI:1528789807
Name:CRITCHLOW-DAWSON, JENNIFER JOY
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:JOY
Last Name:CRITCHLOW-DAWSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:JOY
Other - Last Name:CRITCHLOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5668 S 2450 W
Mailing Address - Street 2:
Mailing Address - City:ROY
Mailing Address - State:UT
Mailing Address - Zip Code:84067-1558
Mailing Address - Country:US
Mailing Address - Phone:801-391-6606
Mailing Address - Fax:
Practice Address - Street 1:533 26TH ST STE 100
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84401-2459
Practice Address - Country:US
Practice Address - Phone:801-645-5455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program