| NPI | 1477925394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARELLE BALDWIN Owner 801-368-8791 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TF0200X Psychologist, Forensic (Licence: UT 7638398-2501) |
| Enumeration Date | 2015-10-30 |
| Last Update Date | 2015-10-30 |