| NPI | 1356869176 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER R. BERGMAN Clinical Psychotherapist 435-557-0311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: UT 136699-3902) |
| Enumeration Date | 2017-08-31 |
| Last Update Date | 2017-08-31 |