| NPI | 1780014019 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALISHA D BYRON Office Manager 801-399-1600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: UT 49619423501) |
| Enumeration Date | 2013-11-22 |
| Last Update Date | 2020-01-15 |