Provider Demographics
NPI:1194606780
Name:TEMPLE, JENIFER LYNN
Entity type:Individual
Prefix:
First Name:JENIFER
Middle Name:LYNN
Last Name:TEMPLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10255 S SPRUCE LEAF DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84009-7142
Mailing Address - Country:US
Mailing Address - Phone:385-321-9373
Mailing Address - Fax:
Practice Address - Street 1:10255 S SPRUCE LEAF DR
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84009-7142
Practice Address - Country:US
Practice Address - Phone:385-321-9373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-10
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)