| NPI | 1366052326 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE NICHOLES Owner/Therapist 801-604-3146 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-08-05 |
| Last Update Date | 2020-08-05 |