| NPI | 1407342058 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENNIE TUCKER President 801-452-1940 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: UT 74547942506) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: UT 74547943501) |
| Enumeration Date | 2018-07-06 |
| Last Update Date | 2018-07-06 |