| NPI | 1760104798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENT R. HALL Director 801-400-5034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 103TC1900X Psychologist Counseling |
| Enumeration Date | 2022-09-15 |
| Last Update Date | 2023-05-30 |