Individual
MS. JENNIFER L WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACMHC
Contact information
Practice address
3509 W 4700 S, TAYLORSVILLE, UT 84129-2846
(801) 990-4300
(801) 967-2127
Mailing address
PO BOX 330, MAGNA, UT 84044-0330
(801) 990-4300
(801) 967-2127
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
8663400-6009
UT
Other
Enumeration date
04/25/2018
Last updated
02/19/2020
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