| NPI | 1598594079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY LARSON Owner 435-632-7545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology Addiction Medicine |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry | |
| Enumeration Date | 2024-07-31 |
| Last Update Date | 2024-08-06 |