| NPI | 1174073746 |
|---|---|
| Doing Business As | PEDIATRIC BEHAVIORAL HEALTH OUTPATIENT SVCS |
| Entity Type | Organization |
| Authorized Contact | EDWARD CLARK Department Chair 801-587-6336 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry |
| Enumeration Date | 2016-10-07 |
| Last Update Date | 2016-10-07 |