| NPI | 1073034823 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNA KARYN LACY WHISLER Manager 435-915-6777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 8229576-3501) |
| Enumeration Date | 2017-07-02 |
| Last Update Date | 2020-08-19 |