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1639630916
MARILEE VANWAGENEN
PROVO, UT
NPI
1639630916
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101Y00000X Counselor
(Licence: UT 140473-3501)
Enumeration Date
2019-03-28
Last Update Date
2019-03-28
Business Address
MARILEE VANWAGENEN LCSW
151 S UNIVERSITY AVE STE 3200
PROVO, UT 84601-4427
Phone number: 801-851-7128
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Mailing Address
MARILEE VANWAGENEN LCSW
151 S UNIVERSITY AVE STE 3200
PROVO, UT 84601-4427
Phone number: 801-851-7128
Copy
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