| NPI | 1760043897 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHEL JERKE Office Manager 801-618-6501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2019-06-28 |
| Last Update Date | 2019-06-28 |