| NPI | 1770641672 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER CRITCHLEY Credentialing Specialist 801-773-7060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 104100000X Social Worker | |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 163WP0808X Registered Nurse, Psych/Mental Health | |
| 164W00000X Licensed Practical Nurse | |
| 174400000X Specialist | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 103T00000X Psychologist | |
| 246Z00000X Specialist/Technologist, Other | |
| 247200000X Technician, Other | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2021-02-10 |