| NPI | 1265639736 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEJKEN THEURER Lcsw 801-499-6990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 125043-3501) |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2020-08-22 |