| NPI | 1619109444 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS COREY HAKES Managing Mamber 801-414-3252 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 03694893501) |
| Enumeration Date | 2009-08-12 |
| Last Update Date | 2009-08-12 |