| NPI | 1730777350 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI G TALL Executive Director 801-953-4371 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics |
| 235Z00000X Speech-Language Pathologist, | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2021-01-08 |
| Last Update Date | 2021-01-08 |