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