| NPI | 1366079097 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB K VICKREY Owner 801-896-8133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2024-08-16 |