Individual
DR. LACEY BAGLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
363 S 400 W, PROVO, UT 84601-4342
(509) 521-1536
Mailing address
363 S 400 W, PROVO, UT 84601-4342
(509) 521-1536
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
109718443902
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
109718443902
MARRIAGE & FAMILY THERAPIST
UT
Enumeration date
07/14/2021
Last updated
07/14/2021
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