Individual
EDWARD DOUGLAS VAKA'UTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
9067 S 1300 W, SUITE 204, WEST JORDAN, UT 84088-5581
(801) 253-4877
(801) 748-2192
Mailing address
9067 S 1300 W STE 204, WEST JORDAN, UT 84088-5582
(801) 253-4877
(801) 748-2192
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
5138304-3501
UT
1041C0700X
Clinical Social Worker
5138304-3501
UT
Other
Enumeration date
04/19/2007
Last updated
03/06/2012
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