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Individual

WILL BRADON JOHN GROVE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CMHC, LPC

Contact information

Practice address
10434 S 1055 W STE 101, SOUTH JORDAN, UT 84095-1521
(801) 355-2846
Mailing address
447 W BEARCAT DR, SALT LAKE CITY, UT 84115-2519
(801) 355-2846

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
12307961-6004
UT
101Y00000X
Counselor
C8327
OR

Other

Enumeration date
08/18/2020
Last updated
12/05/2024
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