NPI | 1700686557 |
---|---|
Entity Type | Organization |
Authorized Contact | JACOB RUSSELL MOSS Member 801-867-5838 |
Organization Subpart ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical |
Additional Taxonomies | 103TC0700X Psychologist, Clinical |
Enumeration Date | 2025-03-19 |
Last Update Date | 2025-03-19 |