| NPI | 1407015787 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAX FORD MCBRIDE President 801-357-7757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: UT 109867-2501) |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2008-07-01 |