| NPI | 1205314747 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS ROCKWELL CLAWSON Sole Proprietor 801-317-3809 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: UT 6720347-3501) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2018-08-06 |
| Last Update Date | 2022-03-14 |