| NPI | 1063125664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZAKARY CALL Provider 801-549-7073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2022-12-29 |
| Last Update Date | 2022-12-29 |