| NPI | 1639060155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL THOMAS CALLISTER Owner 801-210-8038 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2025-07-12 |
| Last Update Date | 2025-07-12 |