Individual provider · Type 1 NPI

Jacob David Vanwagoner

Counselor · Provo, UT

NPI number 1699087718 Active

Practice location

836 N 1375 W
Provo, UT 84604-3049

Call (801) 375-2523 Map

Specialties and licenses

TaxonomyCodeLicense
Counselor Primary 101Y00000XNone listed

Counselor: A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

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About NPI 1699087718

Jacob David Vanwagoner's National Provider Identifier is 1699087718, issued on Jul 6, 2010. The primary taxonomy on file is Counselor (101Y00000X), and the practice location is in Provo, UT. The record was last updated on Jul 6, 2010.