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NPI Code Detail

MEDICARE: ANGEL OAK FAMILY COUNSELING

MEDICARE: ANGEL OAK FAMILY COUNSELING
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency8001124-3902VUT

General Provider Information

NPI Number : 1477946168
Entity Type Code : Organization
Provider Name (Legal Business Name) : ANGEL OAK FAMILY COUNSELING
Provider Business Mailing Address
First Line : 1348 W STATE RD
Second Line : SUITE 101
City : PLEASANT GROVE
State : UT
Zip : 84062-5021
Country : US
Telephone Number : 801-471-7080
Fax Number :
Provider Business Practice Location Address
First Line : 1348 W STATE RD
Second Line : SUITE 101
City : PLEASANT GROVE
State : UT
Zip : 84062-5021
Country : US
Telephone Number : 801-471-7080
Fax Number :
Authorized Official
Title or Position : OWNER
Name : JONATHAN ZABRISKIE
Credential : LMFT
Telephone Number : 801-471-7080
Provider Enumeration Date : 03/05/2015
Last Update Date : 03/05/2015

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Directions to “ANGEL OAK FAMILY COUNSELING ” Practice Location

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