Jacob Larry Butler
Jacob Larry Butler is a Counselor in Provo, Utah. Licensed in Utah. Registered with an NPI since 2014.
- Licensed in
- UT
- In the registry since
- 2014
- Specialties on file
- 2
Practice location Address checks out
1034 N 500 WProvo, UT 84604-3337
Phone: (801) 357-7850
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Specialties & licences
| Occupational Therapist (primary) | Taxonomy 225X00000X · Licence 11351103-4201 (UT) |
|---|---|
| Counselor | Taxonomy 101Y00000X |
Record details
| NPI number | 1972908762 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | October 23, 2014 |
| Last updated in NPPES | November 8, 2021 |
| Certification date | November 8, 2021 |
| Mailing address | 3613 E Golden Eagle Rd, Eagle Mountain, UT 84005-3866 |
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