| NPI | 1548996648 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE WICKERSHAM Owner/Clinical Director 801-554-0006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2022-07-29 |
| Last Update Date | 2022-07-29 |