| NPI | 1003014143 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLE ANDERSON Office Manager 435-752-8010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: UT 112064-2504) |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2008-02-27 |