Bagley, Sandra W

Bagley, Sandra W is an individual health care provider with primary practice located at 3683 Wilde Rose Lane , Salt Lake City UT 84109. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Physician Assistants & Advanced Practice Nursing Providers / Family, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Bagley, Sandra W can be contacted via phone (801) 273-0295.

Contact Information

Primary practice address
3683 Wilde Rose Lane Salt Lake City UT 84109
Phone: (801) 273-0295
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X 1166903502 Utah
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 1166904405 Utah
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 1166903902 Utah

Profile Details

NPI number 1023022415
LBN Legal business name Bagley, Sandra W
Credentials APRN PHD MSW
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 28th, 2006
Last updated Mar 4th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023022415 NPPES
Utah Other U000075209 PTAN

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