Jacob Dastrup Valid NPI
Individual provider · Mental Health Counselor · Pleasant Grove, UT
- NPI
- 1619501368
- Type
- Individual (Type 1)
- Primary specialty
- Mental Health Counselor (Counselor)
- Specialty group
- Behavioral Health & Social Service Providers
- Taxonomy code
- 101YM0800X
- License number
- 13536880 (UT)
- Sex
- Male
- Sole proprietor
- No
- Enumerated
- 2020-03-02
- Last updated
- 2023-08-22
Practice location
487 E 1000 S Ste A
Pleasant Grove, UT 84062-3639
(801) 893-6399