| NPI | 1417788472 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEAN ERICKSON Owner/Nurse Practitioner 801-694-0190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-08-12 |
| Last Update Date | 2024-08-12 |