| NPI | 1770542219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE DALTON BEALL Clinical Director 801-263-6367 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: UT 10844) |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2020-08-22 |