| NPI | 1356690069 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN MELCHER Lcsw 801-347-1778 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 64413263501) |
| Enumeration Date | 2012-09-10 |
| Last Update Date | 2012-09-10 |