| NPI | 1649724659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IVONNE JESSICA CAMPBELL Owner/Therapist 801-879-8984 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: UT 8639940-3501) |
| Enumeration Date | 2016-08-08 |
| Last Update Date | 2016-08-08 |