| NPI | 1821206541 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLETTE DAWSONLOVELESS Program Director 801-785-1169 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 348753-3501) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2016-04-13 |