Organization
LEGACY COUNSELING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN GAWRYS JR. LPC (ADMINISTRATOR)
(801) 822-4892
Entity
Organization
Contact information
Practice address
318 RIDGE DR, ALPINE, UT 84004-2602
(801) 822-4892
Mailing address
318 RIDGE DR, ALPINE, UT 84004-2602
(801) 822-4892
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
53747966004
UT
Other
Enumeration date
02/15/2011
Last updated
02/15/2011
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