| NPI | 1619172806 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLARK B. HOLLADAY Clinical Director 435-623-5044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 2655503501) |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2020-08-22 |