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1184006421
RUTH E VANTASSELL
PROVO, UT
NPI
1184006421
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Former Name
RUTH V. AGLA
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2015-06-23
Last Update Date
2020-11-04
Business Address
RUTH E VANTASSELL CSW
1726 BUCKLEY LN
PROVO, UT 84606-5031
Phone number: 801-373-6562
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Mailing Address
RUTH E VANTASSELL CSW
1726 BUCKLEY LN
PROVO, UT 84606-5031
Phone number: 801-373-6562
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