| NPI | 1336825728 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TREVOR GEE Admin 435-313-1703 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health |
| Enumeration Date | 2023-06-22 |
| Last Update Date | 2023-06-29 |