| NPI | 1417235284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL KELSTROM-SMITH Provider/Owner 801-475-0402 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 4730671-3501) |
| Enumeration Date | 2011-07-28 |
| Last Update Date | 2011-08-12 |