| NPI | 1356659460 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARRETT BONELLA Clinical Supervisor 801-467-6060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: UT 16713) |
| Enumeration Date | 2010-09-23 |
| Last Update Date | 2010-09-23 |