| NPI | 1780921361 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANA THOMSEN Owner/Clinical Director 801-341-2001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 5246675-3501) |
| Enumeration Date | 2013-01-15 |
| Last Update Date | 2013-01-15 |