| NPI | 1194438689 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY BOWEN Clinical Mental Health Counselor 435-557-0655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2022-12-30 |
| Last Update Date | 2022-12-30 |