| NPI | 1518407964 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA TENSMEYER HANSEN Clinical Director 801-400-2569 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: UT 4859896-3902) |
| Enumeration Date | 2017-03-05 |
| Last Update Date | 2017-03-05 |