| NPI | 1104118132 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER COREY HAKES Owner 801-414-3252 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: UT 369489-3501) |
| Enumeration Date | 2011-05-10 |
| Last Update Date | 2021-03-01 |