| NPI | 1710253869 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN R. JOHNSON Owner 435-225-4357 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 5962642-3501) |
| Enumeration Date | 2012-03-22 |
| Last Update Date | 2012-09-27 |