| NPI | 1093374175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AYUEN NUTAKOR CEO 801-662-8956 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0005X Psychiatry & Neurology, Neurodevelopmental Disabilities |
| Enumeration Date | 2019-06-11 |
| Last Update Date | 2019-06-11 |