Individual
ISAAC LONDON WANBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
90 E 200 N, LOGAN, UT 84321-4034
(435) 750-0750
Mailing address
90 E 200 N, LOGAN, UT 84321-4034
(435) 237-2301
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
9572110-3503
UT
1041C0700X
Clinical Social Worker
Primary
9572110-3502
UT
Other
Enumeration date
02/24/2011
Last updated
09/02/2020
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