| NPI | 1487795878 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE MARIE BOELENS Psychologist 801-596-0147 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2011-01-19 |