| NPI | 1215374798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY K DALTON Division Director 385-468-3425 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 20709) |
| Enumeration Date | 2013-05-24 |
| Last Update Date | 2013-05-24 |