Individual
KENNETH SCAGGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8265 W 2700 S, MAGNA, UT 84044-1323
(801) 250-9762
Mailing address
8265 W 2700 S, MAGNA, UT 84044-1323
(801) 250-9762
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
8430191-6005
UT
Other
Enumeration date
01/20/2016
Last updated
01/20/2016
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