| NPI | 1275595688 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SLOANE SMITH Clinical Director 801-783-5560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: UT 58554003502) |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2020-08-22 |