| NPI | 1023590932 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALLAS BEAN Owner 801-335-9382 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 8949648-3501) |
| Enumeration Date | 2018-09-06 |
| Last Update Date | 2019-07-12 |