| NPI | 1073317079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAYANDRA STARNER Owner/Authorized Official 801-200-0807 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-04-01 |
| Last Update Date | 2025-04-01 |