| NPI | 1760861173 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEATRICE DIANE GEORGE Owner 801-390-3447 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 1384993501) |
| Enumeration Date | 2015-05-19 |
| Last Update Date | 2015-05-19 |