Individual
JACOB JESSE ANGLE LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A, CMHC
Contact information
Practice address
3280 W 3500 S STE E, WEST VALLEY CITY, UT 84119-2668
(801) 209-6997
(801) 904-2089
Mailing address
961 W GREENOAKS DR, MURRAY, UT 84123-4922
(801) 831-2268
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/29/2019
Last updated
05/29/2019
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