| NPI | 1649684903 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA BRADLEY Assoc Mental Health Counselor 801-473-7405 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: UT 90438056009) |
| Enumeration Date | 2014-06-16 |
| Last Update Date | 2014-06-16 |