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MR. JAN CHARLES PLUMB
Mental Health >> Counselor >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1700199072
Individual Registrant:MR. JAN CHARLES PLUMB
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
1089 STONE FLY DR BLUFFDALE, UT 84065-5606 US
Tel: 801-816-9981 Fax: --
Tel: 801-816-9981 Fax: --
Contact information for business:
1089 STONE FLY DR BLUFFDALE, UT 84065-5606 US
Tel: 801-816-9981 Fax: --
Tel: 801-816-9981 Fax: --
Registration Information:
NPI: 1700199072
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 101YM0800X | Behavioral Health & Social Service Providers Counselor Mental Health |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
