| NPI | 1184570756 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANNETT EILEEN MADSEN Owner 801-440-4171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2026-03-06 |
| Last Update Date | 2026-03-11 |