| NPI | 1134643596 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | SCOTT STIEFEL Owner 801-410-8254 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry | 
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry | 
| Enumeration Date | 2017-07-27 | 
| Last Update Date | 2022-07-21 |