| NPI | 1184918849 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA BURGERT Therapist 801-513-6866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: UT 48971473501) |
| Enumeration Date | 2011-05-30 |
| Last Update Date | 2011-05-30 |