Mitchel Jay Vanwagoner

NPI #1861056343 in Draper, Utah

Provider Information

NPI Number: 1861056343
Entity Type: Individual
Name: Mitchel Jay Vanwagoner
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker - Clinical
Enumeration Date: Apr 30, 2019
Last Updated: Mar 15, 2023

Practice Location

Address: 12608 S 125 W STE E
City: Draper
State: Utah
ZIP Code: 84020-8437
Phone: (801) 679-6669

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Case Manager/Care Coordinator	171M00000X
Social Worker - Clinical — Clinical	1041C0700X	Primary

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