| NPI | 1790899284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY L BUIE Licensed Clinical Social Worker 801-595-0666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 140182-3501) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2023-12-05 |