| NPI | 1407308737 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID BRENT TATE Owner 435-656-0506 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: UT 2891262501) |
| Enumeration Date | 2016-11-03 |
| Last Update Date | 2016-11-10 |