| NPI | 1801549050 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL RYLAND Partner 801-228-0606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2022-01-28 |
| Last Update Date | 2022-12-09 |