| NPI | 1689145963 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA LYNN BROADHEAD Owner/Medical Director 801-654-3229 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2018-12-11 |
| Last Update Date | 2020-06-17 |