| Doctor Name: | JESSICA DAWN JEWELL |
| NPI Number: | 1164709671 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S. |
| License Number: | 7091340-6004 |
| Business Practice Address: | 2065 Sidewinder Dr Ste. 102 Park City, UT - 840607216 |
| Business Phone Number: | 8016336094 |
| Business Fax Number: | |
| Mailing Address: | Po Box 259, MIDWAY |
| State: | UT |
| Postal Code: | 840490259 |
| Phone Number: | 8016336094 |
| Fax Number: | |
| NPI Enumeration Date: | 11/11/2011 |
| NPI Last Update Date: | 11/11/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 7091340-6004 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |