| NPI | 1245371699 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN SHEPPARD Director 801-581-6228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TA0400X Psychologist Addiction (Substance Use Disorder) (Licence: UT 12188) |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2012-02-29 |