Organization
QUEER FAMILY THERAPY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LACEY BAGLEY LMFT (OWNER)
(509) 521-1536
Entity
Organization
Contact information
Practice address
288 W CENTER ST, PROVO, UT 84601-4419
(509) 521-1536
Mailing address
712 UTAH AVE, PROVO, UT 84606-5217
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
07/17/2025
Last updated
07/17/2025
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