| NPI | 1235417684 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SYLVIA BRUNISHOLZ Program Manager 801-347-0074 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP2701X Psychologist Group Psychotherapy (Licence: UT 0008208) |
| Enumeration Date | 2011-08-02 |
| Last Update Date | 2012-12-06 |