| NPI | 1225817414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN EDGINGTON Owner 801-356-0014 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2023-09-26 |
| Last Update Date | 2023-09-26 |