Individual
MR. AUGUSTO GANCINIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AGENCY AFFILIATED RE
Contact information
Practice address
455 N UNIVERSITY AVE STE 201, PROVO, UT 84601-2867
(385) 446-2466
Mailing address
455 N UNIVERSITY AVE STE 201, PROVO, UT 84601-2867
(385) 446-2466
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
GC60503995
WA
103T00000X
Psychologist
Primary
12458199-2501
UT
Other
Enumeration date
10/17/2014
Last updated
01/28/2026
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