NPI | 1053583435 |
---|---|
Entity Type | Organization |
Authorized Contact | JOSEPH HENRY TABISH Clinical Director 801-463-7520 |
Organization Subpart ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 18922) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: UT 134757) |
1041C0700X Social Worker, Clinical (Licence: UT 13457) | |
Enumeration Date | 2008-03-26 |
Last Update Date | 2012-09-24 |