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 | 2024-11-22 |