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Jacob Dastrup
Mental Health Counselor in Pleasant Grove, Utah
NPI 1619501368

Jacob Dastrup is a Mental Health Counselor based in Pleasant Grove, UT and is specialized in Mental Health. Jacob Dastrup practices in Pleasant Grove, UT. The NPI Number for Jacob Dastrup is 1619501368 and holds a License No. 13536880 (Utah).

The current practice location address for Jacob Dastrup is 487 E 1000 S Ste A, Pleasant Grove, UT and can be reached out via phone at 801-893-6399.

Location: 487 E 1000 S Ste A, Pleasant Grove, UT, 84062-3639
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1619501368
Provider Name
Jacob Dastrup
Credential
Provider Entity Type
Individual
Gender
Male
Address
487 E 1000 S Ste A, Pleasant Grove, UT, 84062-3639
Phone Number
801-893-6399
Fax Number
Provider Enumeration Date
03/02/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
487 E 1000 S Ste A
City
Pleasant Grove
State
Utah
Zip
84062-3639
Phone Number
801-893-6399
Fax Number
person
Provider Business Mailing Address Details
Address
487 E 1000 S Ste A
City
Pleasant Grove
State
Utah
Zip
84062-3639
Phone Number
801-893-6399
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
13536880 (Utah)
Definition
Definition to come...
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