| NPI | 1326326273 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | B. SHANE HARMON Manager 801-475-0402 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 141805-3501) |
| Enumeration Date | 2011-07-26 |
| Last Update Date | 2011-07-26 |