Individual
JEFFREY WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8221 S 700 E, SANDY, UT 84070-0507
(801) 542-7060
Mailing address
8221 S 700 E, SANDY, UT 84070-0507
(801) 425-7060
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
7968562-6004
UT
171M00000X
Case Manager/Care Coordinator
—
—
247200000X
Other Technician
—
—
Other
Enumeration date
07/31/2006
Last updated
09/04/2019
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