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 |