| Doctor Name: | JARED LYNN KUMMER |
| NPI Number: | 1033447412 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | LMSW-12878 |
| Business Practice Address: | 463 S. Lake Powell Blvd Page, AZ - 860400790 |
| Business Phone Number: | 9286455113 |
| Business Fax Number: | |
| Mailing Address: | Po Box 410194, BIG WATER |
| State: | UT |
| Postal Code: | 847412194 |
| Phone Number: | 9286455113 |
| Fax Number: | |
| NPI Enumeration Date: | 11/24/2009 |
| NPI Last Update Date: | 11/24/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | LMSW-12878 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |