| NPI | 1063685295 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE MARIE BOELENS President 801-913-5543 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: UT 110944-2501) |
| Enumeration Date | 2008-04-09 |
| Last Update Date | 2011-01-19 |