| NPI | 1598242893 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATEISHA GOLUB Lcsw 801-520-5749 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2018-07-19 |
| Last Update Date | 2022-12-27 |