Daniel Jacob Wagner, BCBA
Behavior Analyst in Logan, UT. Individual provider (NPI-1).
NPI number1164062741
StatusActive
Last updated in NPPESAug 20, 2025
Details
- NPI
- 1164062741
- Entity type
- Individual (NPI-1)
- Name
- Daniel Jacob Wagner
- Credential
- BCBA
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 10, 2020
- Certification date
- Aug 20, 2025
- Last updated
- Aug 20, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103K00000X | Behavior Analyst | 14004096-2506 | UT | Yes |
Practice location
6405 Old Main HillLogan, UT 84322-3511
Phone 435-797-3403
Mailing address
6405 Old Main HillLogan, UT 84322-6405
Phone 818-462-1168
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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