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Jacob David Vanwagoner
Counselor in Provo, Utah
NPI 1699087718

Jacob David Vanwagoner is a Counselor based in Provo, UT. Jacob David Vanwagoner practices in Provo, UT. The NPI Number for Jacob David Vanwagoner is 1699087718 and holds a License No. (Utah).

The current practice location address for Jacob David Vanwagoner is 836 N 1375 W, Provo, UT and can be reached out via phone at 801-375-2523. You can also correspond with Jacob David Vanwagoner through the mailing address at 836 N 1375 W, PROVO, UT - 84604-3049 (mailing address contact number: ).

Location: 836 N 1375 W, Provo, UT, 84604-3049
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1699087718
Provider Name
Jacob David Vanwagoner
Credential
Provider Entity Type
Individual
Gender
Male
Address
836 N 1375 W, Provo, UT, 84604-3049
Phone Number
801-375-2523
Fax Number
Provider Enumeration Date
07/06/2010
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
836 N 1375 W
City
Provo
State
Utah
Zip
84604-3049
Phone Number
801-375-2523
Fax Number
person
Provider Business Mailing Address Details
Address
836 N 1375 W
City
Provo
State
Utah
Zip
84604-3049
Phone Number
801-375-2523
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
License No.
()
Definition
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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