| NPI | 1780117556 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNY JO TUTTLE Ownver 801-214-1582 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: UT 57349863501) |
| Enumeration Date | 2017-04-07 |
| Last Update Date | 2017-04-07 |