| NPI | 1003568247 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORY SPEAKER Co Owner 801-808-5421 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-01-19 |
| Last Update Date | 2022-01-19 |