| NPI | 1639693344 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DYLAN MATSUMORI Director 435-652-7756 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QS1000X Clinic/Center, Student Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: UT 1244136008) |
| 103T00000X Psychologist (Licence: UT 91334252501) | |
| 1041C0700X Social Worker, Clinical (Licence: UT 1351453501) | |
| 163W00000X Registered Nurse (Licence: UT 3288013102) | |
| 363L00000X Nurse Practitioner (Licence: UT 7343133-4405) | |
| 363L00000X Nurse Practitioner (Licence: UT 50390644405) | |
| 364S00000X Clinical Nurse Specialist (Licence: UT 50390644405) | |
| Enumeration Date | 2017-08-03 |
| Last Update Date | 2022-07-21 |