| NPI | 1265857361 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLOS Y ROBY Owner 801-225-5451 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: UT 111916-2501) |
| Enumeration Date | 2014-02-26 |
| Last Update Date | 2014-02-26 |