| NPI | 1346354875 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY LEE BURNHAM Psychologist 801-748-2270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: UT 108286-2501) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2020-08-22 |