| NPI | 1194271601 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT CLEGG Owner 801-380-9305 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 7442576-3501) |
| Enumeration Date | 2016-08-25 |
| Last Update Date | 2016-12-08 |