| NPI | 1639866924 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANN AHYOU Credentialing 801-679-3031 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2023-04-18 |
| Last Update Date | 2023-04-24 |