| Doctor Name: | JENNIFER MILLAR BEVAN |
| NPI Number: | 1215252028 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | JENNIFER BEVAN CMHC |
| License Number: | 376133-6004 |
| Business Practice Address: | 4527 S 2300 E Suite 206 Holladay, UT - 841174446 |
| Business Phone Number: | 8012720762 |
| Business Fax Number: | 8012743411 |
| Mailing Address: | 4527 S 2300 E, Suite 206 HOLLADAY |
| State: | UT |
| Postal Code: | 841174446 |
| Phone Number: | 8012720762 |
| Fax Number: | 8012743411 |
| NPI Enumeration Date: | 04/05/2010 |
| NPI Last Update Date: | 10/28/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 376133-6004 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |