Jacob David Vanwagoner
Jacob David Vanwagoner is a Counselor in Provo, Utah. Practices as a sole proprietor. Registered with an NPI since 2010.
- In the registry since
- 2010
Practice location Address checks out
836 N 1375 WProvo, UT 84604-3049
Phone: (801) 375-2523
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Specialties & licences
| Counselor (primary) | Taxonomy 101Y00000X |
|---|
Record details
| NPI number | 1699087718 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | July 6, 2010 |
| Last updated in NPPES | July 6, 2010 |
| Mailing address | 836 N 1375 W, Provo, UT 84604-3049 |
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