| NPI | 1417218371 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARMELA J JAVELLANA Owner 801-268-0333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: UT 280094-1205) |
| Enumeration Date | 2012-06-06 |
| Last Update Date | 2012-06-06 |