| NPI | 1407248222 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | MICHELLE MAIN Owner 435-249-0321  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: UT 327705-6009)  | 
| Enumeration Date | 2015-03-03 | 
| Last Update Date | 2015-03-03 |