Provider Demographics
NPI:1538751615
Name:WILLMOTT, JAMIE SILVER (MS, CGC)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:SILVER
Last Name:WILLMOTT
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:LYNN
Other - Last Name:SILVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2291 E FOUR WOODS CIR
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84109-2919
Mailing Address - Country:US
Mailing Address - Phone:617-642-2646
Mailing Address - Fax:
Practice Address - Street 1:320 S WAKARA WAY
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84108-1214
Practice Address - Country:US
Practice Address - Phone:800-469-7423
Practice Address - Fax:801-584-3615
Is Sole Proprietor?:No
Enumeration Date:2021-02-09
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8645867-3601170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS