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Organization
D. B. TUG WAGSTAFF, LPC
Active
Organization
D. B. TUG WAGSTAFF, LPC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUG 'TUG' B. WAGSTAFF M.ED., LPC (OWNER)
(801) 376-4787
Entity
Organization
Contact information
Practice address
1021 E 70 N, AMERICAN FORK, UT 84003-2914
(801) 376-4787
Mailing address
1021 E 70 N, AMERICAN FORK, UT 84003-2914
(801) 376-4787
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
321749-6004
UT
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
321749-6004
UT
Other
Enumeration date
04/29/2010
Last updated
12/12/2012
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