| NPI | 1275800823 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTHA HAM Director 435-674-4464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 1397173501) |
| Enumeration Date | 2011-11-28 |
| Last Update Date | 2011-11-28 |