| NPI | 1346780194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDICE WALTRIP Executive Director/Psychologist 801-613-1048 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: UT 9159603-2501) |
| Enumeration Date | 2017-02-27 |
| Last Update Date | 2017-02-27 |