| NPI | 1225326044 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANTRIL NIELSEN Owner 435-652-1897 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: UT 1494471205) |
| Additional Taxonomies | 364SP0810X Clinical Nurse Specialist, Psych/Mental Health, Child & Family (Licence: UT 68747874408) |
| Enumeration Date | 2011-07-13 |
| Last Update Date | 2015-09-02 |