| NPI | 1205537693 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM AHQUIN Executive D Irector 435-669-6669 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TR0400X Psychologist, Rehabilitation |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 103TP2701X Psychologist, Group Psychotherapy | |
| Enumeration Date | 2023-03-14 |
| Last Update Date | 2023-03-14 |