Healthcare Provider Details

I. General information

NPI: 1255992004
Provider Name (Legal Business Name): DAGNEY M STROSSNER ACMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2019
Last Update Date: 06/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 S GENEVA RD
OREM UT
84059-5803
US

IV. Provider business mailing address

600 S GENEVA RD
OREM UT
84059-5803
US

V. Phone/Fax

Practice location:
  • Phone: 864-420-6132
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number10986572-6009
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: