Individual
JEREMIAH VANDYKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
870 E 9400 S STE 109, SANDY, UT 84094-3687
(385) 238-8522
Mailing address
870 E 9400 S STE 109, SANDY, UT 84094-3687
(385) 238-8522
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
12993816-6009
UT
Other
Enumeration date
01/13/2023
Last updated
01/13/2023
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