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1972042547
AMANDA VAN WAGONER
TAYLORSVILLE, UT
NPI
1972042547
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101Y00000X Counselor
Enumeration Date
2017-02-15
Last Update Date
2017-02-15
Business Address
-- AMANDA VAN WAGONER
6013 S REDWOOD RD
TAYLORSVILLE, UT 84123-5220
Phone number: 801-255-5131
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Mailing Address
-- AMANDA VAN WAGONER
6013 S REDWOOD RD
TAYLORSVILLE, UT 84123-5220
Phone number: 801-255-5131
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