| NPI | 1184167496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DORANN C MITCHELL Owner 801-518-3497 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 141768-3501) |
| Enumeration Date | 2016-11-18 |
| Last Update Date | 2016-11-18 |