| NPI | 1013263524 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANYA NICOLE TABAREZ Csw/Therapist 801-489-9721 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: UT 7946204-3502) |
| Enumeration Date | 2012-08-02 |
| Last Update Date | 2012-08-02 |