Individual
JASON ROBERT WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CMHC
Contact information
Practice address
9844 S 1300 E STE 250, SANDY, UT 84094-4691
(801) 243-2928
(801) 609-3649
Mailing address
9844 S 1300 E STE 250, SANDY, UT 84094-4691
(801) 243-2928
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
7717626-6009
UT
Other
Enumeration date
01/19/2015
Last updated
07/24/2024
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