| NPI | 1215215181 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA MICHELLE SUGERMAN Owner 801-716-4284 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: UT 6278375-2501) |
| Additional Taxonomies | 261QM0801X (Licence: UT 7821510-1205) |
| Enumeration Date | 2011-07-26 |
| Last Update Date | 2016-01-28 |