| NPI | 1396186698 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE R JACKMAN Director/Owner 801-298-0232 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: UT 64977986004) |
| Enumeration Date | 2013-07-15 |
| Last Update Date | 2013-07-15 |