Individual
MS. DIANE VANWAGONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
135 N 900 E, SAINT GEORGE, UT 84770-3024
(801) 541-1308
Mailing address
2297 HILLRISE CIR, SAINT GEORGE, UT 84790-8025
(801) 541-1308
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
332660-6004
UT
101YP2500X
Professional Counselor
—
—
Other
Enumeration date
06/19/2012
Last updated
10/06/2021
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