NPI | 1235682345 |
---|---|
Entity Type | Organization |
Authorized Contact | KELLY BAWDEN Therapist/Director 435-922-0440 |
Organization Subpart ? | Yes |
Primary Taxonomy | 251S00000X (Licence: UT 5360626 3904) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: UT 53606266006) |
101Y00000X Counselor (Licence: UT 53606263904) | |
106H00000X Marriage & Family Therapist (Licence: UT 53606263904) | |
Enumeration Date | 2016-07-26 |
Last Update Date | 2016-07-26 |