Individual
MRS. AMANDA VAN AUSDAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3737 W 4100 S SUITE 100, WEST VALLEY CITY, UT 84120
(801) 548-0079
Mailing address
4460 S HIGHLAND DR, SALT LAKE CITY, UT 84124-3543
(888) 949-4864
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
9054924-6004
UT
Other
Enumeration date
01/11/2013
Last updated
03/11/2025
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