Individual
SHAYDEN JAMES BERTAGNOLLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S. LMFT
Contact information
Practice address
5685 S 1475 E STE 2B, OGDEN, UT 84403-4598
(435) 315-2520
Mailing address
5685 S 1475 E STE 2B, OGDEN, UT 84403-4598
(435) 315-2520
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
9109494-3902
UT
Other
Enumeration date
10/28/2014
Last updated
10/28/2014
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