Individual provider · Type 1 NPI

Jacilyn Nicole Gray, ACMHC

Mental Health Counselor · West Valley, UT

NPI number 1104463520 Active

Practice location

3280 W 3500 S Ste E
West Valley, UT 84119-2668

Mailing address

2466 Green Oaks Dr
Bountiful, UT 84010-3134

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800X11558782-6009 (UT)

Mental Health Counselor: Definition to come...

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About NPI 1104463520

Jacilyn Nicole Gray, ACMHC's National Provider Identifier is 1104463520, issued on Dec 4, 2019. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in West Valley, UT. The record was last updated on Dec 4, 2019.