| NPI | 1386142396 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN AHERN Owner 801-934-3373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2018-01-24 |
| Last Update Date | 2022-09-07 |