| NPI | 1821382771 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL M RICKS Clinical Director 801-995-9110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: UT 17461) |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2011-06-07 |