| NPI | 1366755449 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER JON GRAVETT Officer 435-610-1893 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 7014686-3501) |
| Enumeration Date | 2010-07-19 |
| Last Update Date | 2011-01-18 |