Provider Demographics
NPI:1730838558
Name:WALKER, JENNIFER DAY (MA, MMFT, LMFT)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:DAY
Last Name:WALKER
Suffix:
Gender:F
Credentials:MA, MMFT, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:186 E 1800 N
Mailing Address - Street 2:
Mailing Address - City:NORTH LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84341-2019
Mailing Address - Country:US
Mailing Address - Phone:435-213-3062
Mailing Address - Fax:
Practice Address - Street 1:186 E 1800 N
Practice Address - Street 2:
Practice Address - City:NORTH LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84341-2019
Practice Address - Country:US
Practice Address - Phone:435-213-3062
Practice Address - Fax:435-752-1095
Is Sole Proprietor?:No
Enumeration Date:2022-03-20
Last Update Date:2022-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11297521-3902106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist