| NPI | 1083317598 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH T PORTER Registered Agent/Member 801-999-1384 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 2084S0012X Psychiatry & Neurology Sleep Medicine |
| 261QM0850X Clinic/Center Adult Mental Health | |
| Enumeration Date | 2023-03-23 |
| Last Update Date | 2023-04-28 |